Provider Demographics
NPI:1619343555
Name:DESCOTEAUX, ZACHARY (PHARM D)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:DESCOTEAUX
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 1:23 BRITTANYS WAY
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:ME
Mailing Address - Zip Code:04002-6741
Mailing Address - Country:US
Mailing Address - Phone:207-423-2884
Mailing Address - Fax:
Practice Address - Street 1:335 ALFRED ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3128
Practice Address - Country:US
Practice Address - Phone:207-282-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR45365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist