Individual provider Active NPI

Zachary Tester, RPH

  • Pharmacist
  • Duluth, MN
National Provider Identifier
1790061869
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13783-40 Issued in WI
Practice address
4501 Grand Ave
Duluth, MN 55807-2754
Phone
(218) 628-2897
Fax
(218) 624-5853
NPI assigned
Nov 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 117675 MN
Pharmacist 183500000X 13783-40 WI Primary

Addresses

Primary practice location

4501 Grand Ave
Duluth, MN 55807-2754

Mailing address

4501 Grand Ave
Duluth, MN 55807-2754
Phone (218) 628-2897

Other names 1

  • Zachary Tester Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
117675MNMDPharmacist
13783-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1790061869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072754",
            "telephone_number": "218-628-2897",
            "fax_number": "218-624-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072754",
            "telephone_number": "218-628-2897",
            "fax_number": "218-624-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTER",
        "first_name": "ZACHARY",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117675",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13783-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZACHARY",
            "last_name": "TESTER",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.