Healthcare Provider Details

I. General information

NPI: 1225765993
Provider Name (Legal Business Name): DEWAYNE R. DOYLE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N STATE ST
CONCORD NH
03301-5015
US

IV. Provider business mailing address

26 COTTAGE AVE
MANCHESTER NH
03103-6104
US

V. Phone/Fax

Practice location:
  • Phone: 603-223-6713
  • Fax:
Mailing address:
  • Phone: 636-384-0776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH233226
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3737
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: