Healthcare Provider Details

I. General information

NPI: 1639816440
Provider Name (Legal Business Name): JAMES D BULLARD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 11/12/2022
Certification Date: 11/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 PENN AVE
PITTSBURGH PA
15221-2133
US

IV. Provider business mailing address

991 WALKER CIR
IOWA CITY IA
52245-4716
US

V. Phone/Fax

Practice location:
  • Phone: 412-731-9822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24527
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number7072
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457341
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: