Provider Demographics
NPI:1174821763
Name:SPARKS, ZACHARY CHAMPION (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:CHAMPION
Last Name:SPARKS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MCCURDY AVE N
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-4465
Mailing Address - Country:US
Mailing Address - Phone:256-638-4414
Mailing Address - Fax:256-638-2214
Practice Address - Street 1:42 MCCURDY AVE N
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986-4465
Practice Address - Country:US
Practice Address - Phone:256-638-4414
Practice Address - Fax:256-638-2214
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist