Healthcare Provider Details

I. General information

NPI: 1093631285
Provider Name (Legal Business Name): DYLAN ZHEBREEN HAGEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BRENDTWOOD ROAD
DENVER NC
28037
US

IV. Provider business mailing address

1129 TOWNSHIP PKWY
BELMONT NC
28012-9635
US

V. Phone/Fax

Practice location:
  • Phone: 704-972-2045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34630
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: