Provider Demographics
NPI:1538723796
Name:JENSEN, ZACHARY (PHARM D)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MOREHEAD ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2325
Mailing Address - Country:US
Mailing Address - Phone:308-432-2070
Mailing Address - Fax:
Practice Address - Street 1:230 MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2325
Practice Address - Country:US
Practice Address - Phone:308-432-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist