Provider Demographics
NPI:1790259893
Name:ZEN APOTHECARY INC
Entity Type:Organization
Organization Name:ZEN APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-475-7870
Mailing Address - Street 1:420 N MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-2033
Mailing Address - Country:US
Mailing Address - Phone:951-475-7870
Mailing Address - Fax:951-475-7886
Practice Address - Street 1:420 N MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-2033
Practice Address - Country:US
Practice Address - Phone:951-475-7870
Practice Address - Fax:951-475-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy