Provider Demographics
NPI:1114508843
Name:ADAMS, DYLAN JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:JOSEPH
Last Name:ADAMS
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 1:317 N TELLURIDE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-7809
Mailing Address - Country:US
Mailing Address - Phone:720-847-9355
Mailing Address - Fax:720-847-5289
Practice Address - Street 1:317 N TELLURIDE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-7809
Practice Address - Country:US
Practice Address - Phone:720-847-9355
Practice Address - Fax:720-847-5289
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03951600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist