Provider Demographics
NPI:1578610234
Name:ZION DRUG INC
Entity Type:Organization
Organization Name:ZION DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STIRLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:435-635-4456
Mailing Address - Street 1:72 S 700 W
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-2462
Mailing Address - Country:US
Mailing Address - Phone:435-635-4456
Mailing Address - Fax:435-635-4182
Practice Address - Street 1:72 S 700 W
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-2462
Practice Address - Country:US
Practice Address - Phone:435-635-4456
Practice Address - Fax:435-635-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151969-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========0008Medicaid
UT4601541Medicare UPIN
UT1092020001Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
UT004444032Medicare PIN