Provider Demographics
NPI:1235751355
Name:JOHNSON, ZACHARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:JOHNSON
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 1:3676 N HERMITAGE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:TRANSFER
Mailing Address - State:PA
Mailing Address - Zip Code:16154-1852
Mailing Address - Country:US
Mailing Address - Phone:724-646-1131
Mailing Address - Fax:724-646-1177
Practice Address - Street 1:3676 N HERMITAGE RD STE 6
Practice Address - Street 2:
Practice Address - City:TRANSFER
Practice Address - State:PA
Practice Address - Zip Code:16154-1852
Practice Address - Country:US
Practice Address - Phone:724-646-1131
Practice Address - Fax:724-646-1177
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist