Provider Demographics
NPI:1790301695
Name:TYRCHA, ZACHARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:TYRCHA
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 1:1550 E COUNTY LINE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0990
Mailing Address - Country:US
Mailing Address - Phone:317-534-6258
Mailing Address - Fax:
Practice Address - Street 1:1550 E COUNTY LINE RD STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0990
Practice Address - Country:US
Practice Address - Phone:317-534-6258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026034A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist