Mary Ann Zimmerman, RPH
Individual provider Active NPI Pharmacist · Adams, WI
NPI 1407100555 · NPPES record last updated Oct 27, 2012
Key facts
- NPI
- 1407100555
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11486 (WI)
- Practice address
- 220 W Lincoln St
Adams, WI 53910-9459 - Phone
- (608) 339-3630
- Fax
- (608) 339-9536
- NPI assigned
- Oct 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11486 | WI | Yes |
Addresses
Primary practice location
220 W Lincoln St
Adams, WI 53910-9459
Mailing address
220 W Lincoln St
Adams, WI 53910-9459
Phone (608) 339-3630
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578517710 | Medicaid | WI |
Other providers in Adams, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.