Healthcare Provider Details

I. General information

NPI: 1508259441
Provider Name (Legal Business Name): MARY HULSEY R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 AIRPORT RD STE D
HOT SPRINGS AR
71913-8184
US

IV. Provider business mailing address

1661 AIRPORT RD STE D
HOT SPRINGS AR
71913-8184
US

V. Phone/Fax

Practice location:
  • Phone: 501-625-7500
  • Fax:
Mailing address:
  • Phone: 501-625-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD12908
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH044312
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: