Provider Demographics
NPI:1679101703
Name:ZANE PHARMACY LLC
Entity type:Organization
Organization Name:ZANE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:949-586-7780
Mailing Address - Street 1:23653 EL TORO RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8614
Mailing Address - Country:US
Mailing Address - Phone:949-586-7780
Mailing Address - Fax:
Practice Address - Street 1:23653 EL TORO RD STE A
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8614
Practice Address - Country:US
Practice Address - Phone:360-888-9697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy