TYLER ZACK (NPI# 1083080469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083080469 |
| Entity Type | Individual |
| Full Name | TYLER ZACK |
| Practice Address |
2782 N Cobb Pkwy Kennesaw GA 30152-3472 |
| Practice Telephone | 7704201092 |
| Mailing Telephone | 7704201092 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH026754 | GA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000741958A | 05 |
| Street Address |
2782 N COBB PKWY |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346344272 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2006-09-12 |
| 1992314918 | Monay Christine Sanders | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2020-07-27 |
| 1588127666 | Erin Patel | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2019-04-07 |
| 1255781126 | Judy Schulz | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2016-06-21 |
| 1295191633 | David Higdon Jr. | Pharmacist | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2016-01-14 |
| 1831566223 | Anthony Williams | Pharmacist | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2015-09-01 |
| 1013383330 | Chad Richard | Pharmacist | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2015-08-20 |
| 1376930404 | Mary Rose Locke | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2015-04-15 |
| 1467857516 | Angel Woody | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2014-10-31 |
| 1093069775 | Sonia Louise Mccallister | Nurse Practitioner | 2782 N Cobb Pkwy, Kennesaw, GA 30152-3472 | 2012-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408457 | Sohail Akhtar | Pharmacist | 2153 Dresden Grn Nw, Kennesaw, GA 30144-1285 | 2020-05-15 |
| 1346710548 | Ostoureh Aieda Ahmadpour | Pharmacist | 4346 Alison Jane Dr Ne, Kennesaw, GA 30144-1714 | 2018-11-29 |
| 1396213534 | Damali Aida Hepburn | Pharmacist | 2465 Kaley Walk Nw, Kennesaw, GA 30152-3015 | 2018-11-06 |
| 1720533227 | Anastasia Anugerah | Pharmacist | 2774 N Cobb Pkwy Ste 201, Kennesaw, GA 30152-3469 | 2016-08-25 |
| 1740533561 | Jean Won Chen | Pharmacist | 3645 Bancroft Main Nw, Kennesaw, GA 30144-6012 | 2012-10-17 |
| 1245585835 | Dalia H Eid | Pharmacist | 1636 Woodsford Rd Nw, Kennesaw, GA 30152-7633 | 2012-07-19 |
| 1730434697 | Truman Mitchell Bell IIi | Pharmacist | 6095 Pine Mountain Rd Nw Ste 108, Kennesaw, GA 30152-3332 | 2012-07-17 |
| 1801151857 | Matthew Christopher Jerris | Pharmacist | 740 Barrett Pkwy, Kennesaw, GA 30144-6860 | 2012-07-05 |
| 1588924468 | Alisha T Valdez | Pharmacist | 225 Townpark Dr Nw, Suite 300, Kennesaw, GA 30144-5886 | 2012-05-24 |
| 1275808537 | Evelyn Steiner | Pharmacist | 645 Ernest W Barrett Pkwy Nw, Pharmacy Department Costco, Kennesaw, GA 30144-4922 | 2012-03-19 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.