Basic Information
Provider Information
NPI: 1144472481
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINNEY
FirstName: ZACHARY
MiddleName: GRANT
NamePrefix:  
NameSuffix:  
Credential: PHARM D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 86 MDG UNIT 3215
Address2: RAMSTEIN AB
City: APO
State: AE
PostalCode: 09094
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5955 ZEAMER AVE
Address2:  
City: JBER
State: AK
PostalCode: 995063702
CountryCode: US
TelephoneNumber: 9075803205
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2008
LastUpdateDate: 07/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XS016866AZY Pharmacy Service ProvidersPharmacist 

No ID Information.


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