Provider Demographics
NPI:1376090001
Name:ZOU, YIWEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YIWEN
Middle Name:
Last Name:ZOU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 WALDEN HILLS CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0224
Mailing Address - Country:US
Mailing Address - Phone:412-973-1613
Mailing Address - Fax:
Practice Address - Street 1:4310 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3957
Practice Address - Country:US
Practice Address - Phone:706-860-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist