Provider Demographics
NPI:1821564949
Name:ALLEN, JOSEPH KYLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:KYLE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 N MAIN ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:TAYLOR
Mailing Address - State:AZ
Mailing Address - Zip Code:85939
Mailing Address - Country:US
Mailing Address - Phone:928-536-6885
Mailing Address - Fax:
Practice Address - Street 1:715 N MAIN ST
Practice Address - Street 2:PHARMACY
Practice Address - City:TAYLOR
Practice Address - State:AZ
Practice Address - Zip Code:85939
Practice Address - Country:US
Practice Address - Phone:928-536-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist