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General NPI Number Information
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NPI Number | 1790073070
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Entity Type | Individual
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Provider Name | MICHAEL JAMES MULLEN R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 2200 WESTCHESTER DR ST 126
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City | HIGH POINT
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State | NC
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Zip | 27262-7099
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Country | US
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Telephone | 336-881-1060
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Fax | 336-889-9293
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Provider Business Mailing Address
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Address Line | 1111 MAPLEWOOD AVE
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City | HIGH POINT
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State | NC
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Zip | 27265-9145
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Country | US
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Telephone | 336-841-6461
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Fax | 336-841-6461
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07372
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202006146
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5538
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License Number State | SC
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