Healthcare Provider Details

I. General information

NPI: 1124422423
Provider Name (Legal Business Name): BRIAN J COYLE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9202 COMMERCIAL CENTRE DR
BRIDGEVILLE DE
19933-3822
US

IV. Provider business mailing address

9202 COMMERCIAL CENTRE DR
BRIDGEVILLE DE
19933-3822
US

V. Phone/Fax

Practice location:
  • Phone: 302-337-9785
  • Fax:
Mailing address:
  • Phone: 302-337-9785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03669300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: