Provider Demographics
NPI:1659648343
Name:ZEITER, EDWARD ALLEN (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ALLEN
Last Name:ZEITER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15301 N ORACLE RD UNIT 10
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9404
Mailing Address - Country:US
Mailing Address - Phone:419-280-0203
Mailing Address - Fax:520-825-6891
Practice Address - Street 1:15301 N ORACLE RD UNIT 10
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9404
Practice Address - Country:US
Practice Address - Phone:419-280-0203
Practice Address - Fax:520-825-6891
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist