Provider Demographics
NPI:1235785825
Name:DYER, TAYLOR NATHANIEL (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:NATHANIEL
Last Name:DYER
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 OLD MONROVIA RD NW APT 10211
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-5277
Mailing Address - Country:US
Mailing Address - Phone:205-405-8183
Mailing Address - Fax:
Practice Address - Street 1:1660 OLD MONROVIA RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1544
Practice Address - Country:US
Practice Address - Phone:205-405-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist