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General NPI Number Information
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NPI Number | 1972566420
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Entity Type | Individual
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Provider Name | SUSAN ALICE BULLARD PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 508 FULTON ST PHARMACY SERVICE (119)
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City | DURHAM
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State | NC
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Zip | 27705-3875
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Country | US
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Telephone | 919-286-0411
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Fax | 919-286-6987
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Provider Business Mailing Address
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Address Line | 508 FULTON ST
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City | DURHAM
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State | NC
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Zip | 27705-3875
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 12406
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS27871
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License Number State | FL
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