Provider Demographics
NPI:1639780216
Name:CLOUSE, ZACHARY DONALD (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DONALD
Last Name:CLOUSE
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 1:670 S STATE ROUTE 587
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-9501
Mailing Address - Country:US
Mailing Address - Phone:419-722-6782
Mailing Address - Fax:
Practice Address - Street 1:1501 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3752
Practice Address - Country:US
Practice Address - Phone:419-424-1828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440099183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist