Provider Demographics
NPI:1477829406
Name:ZVIBLEMAN, ALBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:ZVIBLEMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 PICKFAIR DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3626
Mailing Address - Country:US
Mailing Address - Phone:314-434-2510
Mailing Address - Fax:314-434-2510
Practice Address - Street 1:1830 PICKFAIR DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3626
Practice Address - Country:US
Practice Address - Phone:314-434-2510
Practice Address - Fax:314-434-2510
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO258051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist