Provider Demographics
NPI:1346522810
Name:DAMPIER, BRET TYSON (RPH)
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:TYSON
Last Name:DAMPIER
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 1:2521 NW 91ST DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9148
Mailing Address - Country:US
Mailing Address - Phone:352-332-3494
Mailing Address - Fax:
Practice Address - Street 1:90 SW 250TH ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3431
Practice Address - Country:US
Practice Address - Phone:352-472-2253
Practice Address - Fax:352-472-5515
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist