Provider Demographics
NPI:1548480882
Name:ZAMANIAN, AHMAD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:ZAMANIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:FRED
Other - Middle Name:
Other - Last Name:ZAMANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:453 GRACELAND DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2704
Mailing Address - Country:US
Mailing Address - Phone:505-256-7349
Mailing Address - Fax:
Practice Address - Street 1:11417 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112
Practice Address - Country:US
Practice Address - Phone:505-291-1600
Practice Address - Fax:505-291-1604
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00005362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist