Provider Demographics
NPI:1134897655
Name:GRIMMETT, ZACHARY (PHARMD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:GRIMMETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:BELFRY
Mailing Address - State:KY
Mailing Address - Zip Code:41514-0441
Mailing Address - Country:US
Mailing Address - Phone:606-625-7701
Mailing Address - Fax:
Practice Address - Street 1:306 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4095
Practice Address - Country:US
Practice Address - Phone:606-237-1735
Practice Address - Fax:855-857-2805
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0012326183500000X
KY021372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist