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General NPI Number Information
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NPI Number | 1497321129
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Entity Type | Individual
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Provider Name | CHARLES ROBERT PULEO JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 1310 24TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2637
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Country | US
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Telephone | 615-873-7054
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Fax |
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Provider Business Mailing Address
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Address Line | 510 BUTLER AVE
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City | MARTINSBURG
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State | WV
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Zip | 25405-9990
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 29716
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License Number State | NC
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