Provider Demographics
NPI:1417203258
Name:ZEGARAC, ASHLEY M
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:M
Last Name:ZEGARAC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7966 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1021
Mailing Address - Country:US
Mailing Address - Phone:440-292-6187
Mailing Address - Fax:
Practice Address - Street 1:7966 TWIN OAKS DR
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1021
Practice Address - Country:US
Practice Address - Phone:440-292-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03132267OtherOHIO BOARD OF PHARMACY