Provider Demographics
NPI:1891093506
Name:METHENY, ZACHARY MILAN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:MILAN
Last Name:METHENY
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1701
Mailing Address - Country:US
Mailing Address - Phone:304-329-2212
Mailing Address - Fax:304-329-3803
Practice Address - Street 1:415 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1701
Practice Address - Country:US
Practice Address - Phone:304-329-2212
Practice Address - Fax:304-329-3803
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist