Provider Demographics
NPI:1700285798
Name:SEAMONS, ZIVILE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ZIVILE
Middle Name:
Last Name:SEAMONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 CALLE LOMA NORTE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1234
Mailing Address - Country:US
Mailing Address - Phone:773-208-1996
Mailing Address - Fax:
Practice Address - Street 1:5721 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-1868
Practice Address - Country:US
Practice Address - Phone:505-216-1492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist