Healthcare Provider Details

I. General information

NPI: 1144590654
Provider Name (Legal Business Name): PAULA MARIE HULL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2012
Last Update Date: 01/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E EUCLID AVE
DES MOINES IA
50313-4507
US

IV. Provider business mailing address

12929 TIMBERLINE DR
URBANDALE IA
50323-1717
US

V. Phone/Fax

Practice location:
  • Phone: 515-243-0601
  • Fax: 515-288-8640
Mailing address:
  • Phone: 515-254-9081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17746
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: