Provider Demographics
NPI:1861509424
Name:ZIAS, JODY LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:ZIAS
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 1:125 POWERS RD
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-2739
Mailing Address - Country:US
Mailing Address - Phone:304-723-1911
Mailing Address - Fax:
Practice Address - Street 1:900 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:WV
Practice Address - Zip Code:26047
Practice Address - Country:US
Practice Address - Phone:304-564-3272
Practice Address - Fax:304-564-3276
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005428183500000X
PARP040561R183500000X
OH03320315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist