Provider Demographics
NPI:1912399221
Name:BOGDANSKI, ZACHARY JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JOHN
Last Name:BOGDANSKI
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 1:1010 E IRELAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-2665
Mailing Address - Country:US
Mailing Address - Phone:574-299-0154
Mailing Address - Fax:574-299-2840
Practice Address - Street 1:1010 E IRELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-2665
Practice Address - Country:US
Practice Address - Phone:574-299-0154
Practice Address - Fax:574-299-2840
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025321A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist