Provider Demographics
NPI:1770828808
Name:EARHART, ZACHARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:EARHART
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 1:5110 S POWER RD
Mailing Address - Street 2:T-1959
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-4201
Mailing Address - Country:US
Mailing Address - Phone:480-281-0268
Mailing Address - Fax:
Practice Address - Street 1:5110 S POWER RD
Practice Address - Street 2:T-1959
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-4201
Practice Address - Country:US
Practice Address - Phone:480-281-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist