Provider Demographics
NPI:1952903486
Name:CLARY, ZACHARY TYLER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:TYLER
Last Name:CLARY
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 1:1165 WALMART WAY
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-1471
Mailing Address - Country:US
Mailing Address - Phone:270-352-2730
Mailing Address - Fax:
Practice Address - Street 1:1165 WALMART WAY
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1471
Practice Address - Country:US
Practice Address - Phone:270-352-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist