Provider Demographics
NPI:1295026177
Name:ZACHARIAN, DAVID MIKAEL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MIKAEL
Last Name:ZACHARIAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 F 1/4 RD UNIT 842
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1258
Mailing Address - Country:US
Mailing Address - Phone:720-935-3511
Mailing Address - Fax:
Practice Address - Street 1:1834 N 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7612
Practice Address - Country:US
Practice Address - Phone:970-243-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist