Provider Demographics
NPI:1619058633
Name:ZINK, ADAM RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:RYAN
Last Name:ZINK
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 1:3285 MANITOU PARK RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-8955
Mailing Address - Country:US
Mailing Address - Phone:574-223-6956
Mailing Address - Fax:
Practice Address - Street 1:101 W ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:IN
Practice Address - Zip Code:46910-9997
Practice Address - Country:US
Practice Address - Phone:574-893-4413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020169A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100295900Medicaid
IN1506469OtherNABP NUMBER