Healthcare Provider Details

I. General information

NPI: 1518630433
Provider Name (Legal Business Name): THOMAS JOHN ULI RPH, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 N COTTON LN
SURPRISE AZ
85388-9607
US

IV. Provider business mailing address

12808 W TUCKEY LN
GLENDALE AZ
85307-1973
US

V. Phone/Fax

Practice location:
  • Phone: 623-455-7902
  • Fax: 623-455-7903
Mailing address:
  • Phone: 623-533-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS025248
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: