Provider Demographics
NPI:1336499185
Name:ALLEN, DENNIS JAMES (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAMES
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:JAMES
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPH
Mailing Address - Street 1:42234 N STONEMARK DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-551-1347
Mailing Address - Fax:
Practice Address - Street 1:8240 W DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2125
Practice Address - Country:US
Practice Address - Phone:623-572-7487
Practice Address - Fax:623-572-8024
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist