Provider Demographics
NPI:1710588058
Name:PIZARRO, ZAYDA NOEMI (RPH)
Entity Type:Individual
Prefix:
First Name:ZAYDA
Middle Name:NOEMI
Last Name:PIZARRO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 THORNCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-4523
Mailing Address - Country:US
Mailing Address - Phone:269-274-4220
Mailing Address - Fax:
Practice Address - Street 1:12737 6 MILE RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-8368
Practice Address - Country:US
Practice Address - Phone:269-979-7671
Practice Address - Fax:269-979-7674
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315112831OtherCONTROLLED SUBSTANCE LICENSE
195501713963OtherBLS PROVIDER
MI5302411022OtherPHARMACIST LICENSE