Healthcare Provider Details

I. General information

NPI: 1740574185
Provider Name (Legal Business Name): CHERI LORRAINE BULL-HUERTA R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 COVERED VLG
BELDING MI
48809-1600
US

IV. Provider business mailing address

240 COVERED VLG
BELDING MI
48809-1600
US

V. Phone/Fax

Practice location:
  • Phone: 616-794-2290
  • Fax: 888-871-0219
Mailing address:
  • Phone: 616-794-2290
  • Fax: 888-871-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302029276
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: