Provider Demographics
NPI:1417678111
Name:ZOFCIN, ADAM HUGH
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:HUGH
Last Name:ZOFCIN
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 1:1622 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1658
Mailing Address - Country:US
Mailing Address - Phone:307-630-1397
Mailing Address - Fax:
Practice Address - Street 1:1622 OXFORD DR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1658
Practice Address - Country:US
Practice Address - Phone:307-630-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYT2796183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician