Healthcare Provider Details

I. General information

NPI: 1629345228
Provider Name (Legal Business Name): SCOTT ALLEN HULA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2011
Last Update Date: 11/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 VILLAGE BLVD
LINCOLN NE
68516-4759
US

IV. Provider business mailing address

4650 EAGLE RIDGE RD
LINCOLN NE
68516-3025
US

V. Phone/Fax

Practice location:
  • Phone: 402-421-7119
  • Fax:
Mailing address:
  • Phone: 402-690-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12673
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: