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General NPI Number Information
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NPI Number | 1467242883
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Entity Type | Organization
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Legal Business Name | MULLEN PHARMACY PA INC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 219 N MAIN ST
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City | ULYSSES
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State | KS
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Zip | 67880-2130
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Country | US
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Telephone | 620-356-1446
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Fax | 620-356-5381
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Provider Business Mailing Address
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Address Line | PO BOX 570
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City | ULYSSES
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State | KS
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Zip | 67880-0570
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Country | US
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Telephone | 620-356-1446
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Fax | 620-356-5381
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Authorized Official
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Title or Position | OWNER
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Name | TYSON MULLEN
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Credential | PHARMD
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Telephone | 620-356-1446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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