Provider Demographics
NPI:1659924934
Name:GOLDEN, ZACHARY EDWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:EDWARD
Last Name:GOLDEN
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 1:4924 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-3344
Mailing Address - Country:US
Mailing Address - Phone:219-902-3676
Mailing Address - Fax:
Practice Address - Street 1:651 W US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1649
Practice Address - Country:US
Practice Address - Phone:219-865-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028272A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist