Provider Demographics
NPI:1417551664
Name:WOFFORD, ZACHARY LEE
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:LEE
Last Name:WOFFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:AL
Mailing Address - Zip Code:35988-0076
Mailing Address - Country:US
Mailing Address - Phone:256-601-6077
Mailing Address - Fax:
Practice Address - Street 1:3303 CLAIRMONT AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35222-3105
Practice Address - Country:US
Practice Address - Phone:205-322-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist