Provider Demographics
NPI:1518160134
Name:BOOGMAN, ZELDA (RPH)
Entity Type:Individual
Prefix:
First Name:ZELDA
Middle Name:
Last Name:BOOGMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4634 ARAPAHO LOOKOUT
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9692
Mailing Address - Country:US
Mailing Address - Phone:406-256-2292
Mailing Address - Fax:
Practice Address - Street 1:611 N 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1112
Practice Address - Country:US
Practice Address - Phone:406-259-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist