Provider Demographics
NPI:1407331945
Name:WOOLDRIDGE, ZACHARY PAUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:PAUL
Last Name:WOOLDRIDGE
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 1:547 ALCOA TRL
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5521
Mailing Address - Country:US
Mailing Address - Phone:423-836-3871
Mailing Address - Fax:
Practice Address - Street 1:244 S HALL RD
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2642
Practice Address - Country:US
Practice Address - Phone:865-977-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000425871835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000042587OtherTENNESSEE PHARMACY BOARD