Provider Demographics
NPI:1407386337
Name:WILLIAMS, ZACHARY ZANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ZANE
Last Name:WILLIAMS
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:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:MN
Mailing Address - Zip Code:56178-0136
Mailing Address - Country:US
Mailing Address - Phone:605-203-0134
Mailing Address - Fax:
Practice Address - Street 1:205 6TH AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MN
Practice Address - Zip Code:56256-1308
Practice Address - Country:US
Practice Address - Phone:320-598-3864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6474183500000X
MN123249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist