Provider Demographics
NPI:1659033223
Name:GASSEL, ZACHARY JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JAMES
Last Name:GASSEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 MANZANA CT NW APT 2B
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-5724
Mailing Address - Country:US
Mailing Address - Phone:248-826-8905
Mailing Address - Fax:
Practice Address - Street 1:8364 BYRON CENTER AVE SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-7805
Practice Address - Country:US
Practice Address - Phone:616-878-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413880183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist