Basic Information
| Provider Information | |||||||||
| NPI: | 1922524263 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TERRILL | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHARMD, MBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ADRIAN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492211759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172631800 | ||||||||
| FaxNumber: | 5172649965 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ADRIAN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492211759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172631800 | ||||||||
| FaxNumber: | 5172649965 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2017 | ||||||||
| LastUpdateDate: | 10/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 03237429-2 | OH | N | Pharmacy Service Providers | Pharmacist | 183500000X | 5302046447 | MI | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.