Provider Demographics
NPI:1942514617
Name:HOLMES, ZACHARIAH (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ZACHARIAH
Middle Name:
Last Name:HOLMES
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 1:3800 S RUSSELL ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8525
Mailing Address - Country:US
Mailing Address - Phone:406-549-7071
Mailing Address - Fax:406-549-7659
Practice Address - Street 1:3800 S RUSSELL ST
Practice Address - Street 2:PHARMACY
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8525
Practice Address - Country:US
Practice Address - Phone:406-549-7071
Practice Address - Fax:406-549-7659
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6284183500000X
WAPH60169066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist