Provider Demographics
NPI:1770813586
Name:ZINK, MARY BETH (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:ZINK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-7974
Mailing Address - Country:US
Mailing Address - Phone:574-223-3625
Mailing Address - Fax:
Practice Address - Street 1:1025 W 9TH ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46975-7974
Practice Address - Country:US
Practice Address - Phone:574-223-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013443A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist