Zachary Steven Mayberry
Pharmacist in Charleston, IL. Individual provider (NPI-1).
NPI number1982431979
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1982431979
- Entity type
- Individual (NPI-1)
- Name
- Zachary Steven Mayberry
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2024
- Certification date
- Sep 12, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 051305931 | IL | Yes |
Practice location
2250 Lincoln AveCharleston, IL 61920-3028
Phone 217-345-9458
Mailing address
2250 Lincoln AveCharleston, IL 61920-3028
Phone 217-345-9458
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