Provider Demographics
NPI:1336819366
Name:LAWRENCE, ZACHARY RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:RYAN
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:ZAC
Other - Middle Name:RYAN
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9341 THREAVE PL APT 104
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2029
Mailing Address - Country:US
Mailing Address - Phone:662-285-7226
Mailing Address - Fax:
Practice Address - Street 1:7251 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:HORN LAKE
Practice Address - State:MS
Practice Address - Zip Code:38637-1410
Practice Address - Country:US
Practice Address - Phone:662-349-8336
Practice Address - Fax:662-349-8337
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45483183500000X
MSE-100398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist