Provider Demographics
NPI:1891065678
Name:TENNANT, ZACHARY M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:M
Last Name:TENNANT
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 1:512A CHURCH ST. S.
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-1615
Mailing Address - Country:US
Mailing Address - Phone:304-514-5511
Mailing Address - Fax:304-514-5512
Practice Address - Street 1:512A CHURCH ST S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1615
Practice Address - Country:US
Practice Address - Phone:304-514-5511
Practice Address - Fax:304-514-5512
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007264183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist