Provider Demographics
NPI:1417331430
Name:ZINOVIA & CO LLC
Entity Type:Organization
Organization Name:ZINOVIA & CO LLC
Other - Org Name:HOME TOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAVICHAND
Authorized Official - Middle Name:
Authorized Official - Last Name:YALAMANCHILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-292-1423
Mailing Address - Street 1:101 S VANCE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4239
Mailing Address - Country:US
Mailing Address - Phone:919-292-1423
Mailing Address - Fax:919-292-1732
Practice Address - Street 1:101 S VANCE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4239
Practice Address - Country:US
Practice Address - Phone:919-292-1423
Practice Address - Fax:919-292-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC126283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153324OtherPK
NC12628OtherPHARMACY PERMIT NUMBER