Healthcare Provider Details

I. General information

NPI: 1659447324
Provider Name (Legal Business Name): ANN HULL DPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 VALLEY DR
PAULS VALLEY OK
73075-6613
US

IV. Provider business mailing address

918 E 7TH ST
SULPHUR OK
73086-5023
US

V. Phone/Fax

Practice location:
  • Phone: 405-238-5501
  • Fax: 405-238-9261
Mailing address:
  • Phone: 580-622-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8376
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: