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Active NPI 1568016103 Individual Practitioner Male Practitioner

Dylan Broadwater

Pharmacist • Fairchild Afb, WA

Professional Overview & Biography Verified Profile Summary

Dylan Broadwater is a registered healthcare professional specializing in Pharmacist in Fairchild Afb, WA. Practice services are available at 701 HOSPITAL LOOP under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

701 Hospital Loop

Fairchild Afb, WA 990118704

Telephone 5092473355
Associated Practice Facility / Clinic
🏢 92d Medgrp-Fairchild Facility NPI 1104888288

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Fairchild Afb, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.0 Yrs
Regional Practice Density
5 Specialists

Practicing in Fairchild Afb, WA (7956 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-06-30
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License CO PHA.0022534

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1669801320

Doctor of Pharmacy (Pharm.D.)

NPI 1770674772

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location June 30, 2023

Registered at 701 HOSPITAL LOOP, FAIRCHILD AFB, WA 990118704 (Tel: 5092473355)

NPI Profile Active July 31, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location July 31, 2019

Registered at 90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 836481062 (Tel: 3127287485)

📍
Updated Business Mailing Address July 31, 2019

Registered at 8433A BEAR LOOP, MOUNTAIN HOME AFB, ID 836485101 (Tel: 3862250011)

👤
Provider Name / Credentials Updated July 31, 2019

Recorded as DYLAN BROADWATER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2019

Pharmacist (License #PHA.0022534 in CO)

🟢
Initial NPI Registration & Enumeration July 31, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568016103
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 31, 2019
Last Update: June 30, 2023
Sole Proprietor: No

Mailing Address

8433a Bear Loop

Mountain Home Afb, ID 836485101

Phone: 3862250011

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.