Provider Demographics
NPI:1598368185
Name:BOUAKAR, ZIAD (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZIAD
Middle Name:
Last Name:BOUAKAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PARK RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35127-1805
Mailing Address - Country:US
Mailing Address - Phone:205-744-1021
Mailing Address - Fax:205-744-9156
Practice Address - Street 1:108 PARK RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:AL
Practice Address - Zip Code:35127-1805
Practice Address - Country:US
Practice Address - Phone:205-744-1021
Practice Address - Fax:205-744-9156
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist