Provider Demographics
NPI:1154307023
Name:ALDER, DENNIS MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:ALDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:USCG HQ, COMDT (CG-1122)
Mailing Address - Street 2:2100 2ND STREET ROOM 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:757-483-8600
Mailing Address - Fax:757-483-8610
Practice Address - Street 1:USCG ISC PHARMACY DEPARTMENT
Practice Address - Street 2:4000 COAST GUARD BLVD
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2199
Practice Address - Country:US
Practice Address - Phone:757-483-8600
Practice Address - Fax:757-483-8610
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT00002364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist