Provider Demographics
NPI:1336011865
Name:WHITT, DYLAN MATHEW (PHARMACIST INTERN)
Entity type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:MATHEW
Last Name:WHITT
Suffix:
Gender:M
Credentials:PHARMACIST INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143-2303
Mailing Address - Country:US
Mailing Address - Phone:304-767-9810
Mailing Address - Fax:
Practice Address - Street 1:101 21ST ST
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143-1739
Practice Address - Country:US
Practice Address - Phone:304-755-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVIN0010766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty