Provider Demographics
NPI:1295045094
Name:ZIRCHER, JONATHAN A (RPH)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:A
Last Name:ZIRCHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:786 DAYTON DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-9414
Mailing Address - Country:US
Mailing Address - Phone:317-506-7968
Mailing Address - Fax:
Practice Address - Street 1:801 CONGRESSIONAL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5646
Practice Address - Country:US
Practice Address - Phone:317-818-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020769A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist