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NPI Code Detail

MEDICARE: DYLAN HALL

MEDICARE: DYLAN HALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist20896NV

General Provider Information

NPI Number : 1235701483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN HALL
Provider Business Mailing Address
First Line : 10705 PRIMROSE ARBOR AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-4200
Country : US
Telephone Number : 702-370-5842
Fax Number :
Provider Business Practice Location Address
First Line : 7151 W CRAIG RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-6511
Country : US
Telephone Number : 702-839-9256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2021
Last Update Date : 07/15/2021

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Directions to “ DYLAN HALL ” Practice Location

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