Provider Demographics
NPI:1669811147
Name:MOLNAR, TYLER ALYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ALYN
Last Name:MOLNAR
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 1:804 MOTHERWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5109
Mailing Address - Country:US
Mailing Address - Phone:440-319-6808
Mailing Address - Fax:
Practice Address - Street 1:401 N ARROYO GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3974
Practice Address - Country:US
Practice Address - Phone:702-436-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18358183500000X
OHRPH.03131724-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist