Provider Demographics
NPI:1063988004
Name:WOODWARD, ZACHARY COLLINS (CPHT)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:COLLINS
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BILL WILLIAMSON CT # A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9296
Mailing Address - Country:US
Mailing Address - Phone:803-447-6757
Mailing Address - Fax:
Practice Address - Street 1:113 BILL WILLIAMSON CT # A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9296
Practice Address - Country:US
Practice Address - Phone:803-447-6757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35057183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician