Provider Demographics
NPI:1164019733
Name:ZEPPA, JOSEPH BENJAMIN (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BENJAMIN
Last Name:ZEPPA
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 1:626 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2210
Mailing Address - Country:US
Mailing Address - Phone:231-935-0185
Mailing Address - Fax:231-935-1426
Practice Address - Street 1:626 W FRONT ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2210
Practice Address - Country:US
Practice Address - Phone:231-935-0185
Practice Address - Fax:231-935-1426
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302417089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty