Provider Demographics
NPI:1962978072
Name:ZACHARY, MARK STEPHEN (BS, RPH)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:STEPHEN
Last Name:ZACHARY
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 HWY 107 S./BOX 236
Mailing Address - Street 2:P.O. BOX 236
Mailing Address - City:CASHIERS
Mailing Address - State:NC
Mailing Address - Zip Code:28717-0236
Mailing Address - Country:US
Mailing Address - Phone:828-743-2114
Mailing Address - Fax:828-743-2114
Practice Address - Street 1:CASHIERS SHOPPING CENTER, HWY 64 EAST
Practice Address - Street 2:#72
Practice Address - City:CASHIERS
Practice Address - State:NC
Practice Address - Zip Code:28717-0246
Practice Address - Country:US
Practice Address - Phone:828-743-3114
Practice Address - Fax:828-743-9214
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist