Provider Demographics
NPI:1275637993
Name:T ZENON PHARMACEUTICALS
Entity Type:Organization
Organization Name:T ZENON PHARMACEUTICALS
Other - Org Name:PHARMACY MATTERS #201
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-337-2492
Mailing Address - Street 1:230 SCOTT CT
Mailing Address - Street 2:SUITE 238
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3997
Mailing Address - Country:US
Mailing Address - Phone:319-337-2492
Mailing Address - Fax:
Practice Address - Street 1:230 SCOTT CT
Practice Address - Street 2:SUITE 238
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3997
Practice Address - Country:US
Practice Address - Phone:319-337-2492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0481101Medicaid
IA0481101Medicaid