Basic Information
| Provider Information | |||||||||
| NPI: | 1912546615 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOGIODICE | ||||||||
| FirstName: | ZACHARIAH | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 86 MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014532106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073415325 | ||||||||
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| Practice Location | |||||||||
| Address1: | 242 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | GARDNER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014401373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786323420 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2019 | ||||||||
| LastUpdateDate: | 12/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | PH235933 | MA | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.