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NPI Code Detail

MEDICARE: MULLEN PHARMACY PA INC

MEDICARE: MULLEN PHARMACY PA INC
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
1261QP2300XPrimary Care Clinic/Center
23336C0002XClinic Pharmacy

General Provider Information

NPI Number : 1467242883
Entity Type Code : Organization
Provider Name (Legal Business Name) : MULLEN PHARMACY PA INC
Provider Business Mailing Address
First Line : PO BOX 570
Second Line :
City : ULYSSES
State : KS
Zip : 67880-0570
Country : US
Telephone Number : 620-356-1446
Fax Number : 620-356-5381
Provider Business Practice Location Address
First Line : 219 N MAIN ST
Second Line :
City : ULYSSES
State : KS
Zip : 67880-2130
Country : US
Telephone Number : 620-356-1446
Fax Number : 620-356-5381
Authorized Official
Title or Position : OWNER
Name : TYSON MULLEN
Credential : PHARMD
Telephone Number : 620-356-1446
Provider Enumeration Date : 05/08/2025
Last Update Date : 06/13/2025

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Directions to “MULLEN PHARMACY PA INC ” Practice Location

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