Provider Demographics
NPI:1396397105
Name:MCLEOD, ZACH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACH
Middle Name:
Last Name:MCLEOD
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 1:1957 S BEVERLYE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-5909
Mailing Address - Country:US
Mailing Address - Phone:334-233-1971
Mailing Address - Fax:
Practice Address - Street 1:591 S UNION AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-1834
Practice Address - Country:US
Practice Address - Phone:334-774-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist