Provider Demographics
NPI:1497046916
Name:ZITTERKOB, HENRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:ZITTERKOB
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 1:835 S. HWY 395
Mailing Address - Street 2:PHARMACY
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838
Mailing Address - Country:US
Mailing Address - Phone:541-567-7805
Mailing Address - Fax:541-567-4783
Practice Address - Street 1:835 S. HWY 395
Practice Address - Street 2:PHARMACY
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838
Practice Address - Country:US
Practice Address - Phone:541-567-7805
Practice Address - Fax:541-567-4783
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0009168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist