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NPI Code Detail

MEDICARE: DYLAN WEGLEY RPH

MEDICARE: DYLAN WEGLEY RPH
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
1183500000XPharmacist55899CA

General Provider Information

NPI Number : 1871572255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN WEGLEY RPH
Provider Business Mailing Address
First Line : 8027 N CEDAR AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-4827
Country : US
Telephone Number : 559-431-1002
Fax Number : 559-431-1099
Provider Business Practice Location Address
First Line : 8027 N CEDAR AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-4827
Country : US
Telephone Number : 559-431-1002
Fax Number : 559-431-1099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 01/23/2010

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Directions to “ DYLAN WEGLEY RPH” Practice Location

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