Healthcare Provider Details

I. General information

NPI: 1669918744
Provider Name (Legal Business Name): DONALD HULKA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US

IV. Provider business mailing address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-5264
  • Fax: 707-253-5766
Mailing address:
  • Phone: 707-253-5264
  • Fax: 707-253-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH36693
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03211371
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: