Provider Demographics
NPI:1164428710
Name:Z-MED INC
Entity Type:Organization
Organization Name:Z-MED INC
Other - Org Name:TOWN AND COUNTRY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHARAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:307-634-6662
Mailing Address - Street 1:514 S GREELEY HWY
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007-2852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:514 S GREELEY HWY
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82007-2852
Practice Address - Country:US
Practice Address - Phone:307-634-6662
Practice Address - Fax:307-634-6670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
WY52014793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5201479OtherOTHER ID NUMBER-COMMERCIAL NUMBER
5201479OtherOTHER ID NUMBER
5201479OtherOTHER ID NUMBER-COMMERCIAL NUMBER