Provider Demographics
NPI:1689229627
Name:FRENCH, DYLAN DOUGLAS (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:DOUGLAS
Last Name:FRENCH
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 1:6232 NACIONAL RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6174
Mailing Address - Country:US
Mailing Address - Phone:505-803-4584
Mailing Address - Fax:
Practice Address - Street 1:3701 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5623
Practice Address - Country:US
Practice Address - Phone:505-256-9443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist