Provider Demographics
NPI:1255622593
Name:ZHVANIA, IVERI GURI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:IVERI
Middle Name:GURI
Last Name:ZHVANIA
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 1:838 LEGENDS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-6576
Mailing Address - Country:US
Mailing Address - Phone:318-235-9218
Mailing Address - Fax:
Practice Address - Street 1:115 SOUTHLAND VLG
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36079-3044
Practice Address - Country:US
Practice Address - Phone:334-566-6541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist