Provider Demographics
NPI:1568945657
Name:RILEY, ZACHARY LONG (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:LONG
Last Name:RILEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:AL
Mailing Address - Zip Code:35470-1246
Mailing Address - Country:US
Mailing Address - Phone:205-725-8118
Mailing Address - Fax:205-392-7006
Practice Address - Street 1:583 4TH AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:AL
Practice Address - Zip Code:36925-2008
Practice Address - Country:US
Practice Address - Phone:205-725-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist