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General NPI Number Information
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NPI Number | 1992702187
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Entity Type | Organization
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Legal Business Name | JOHN BULL PHARMACY, INC
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2124 38TH ST
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City | KENNER
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State | LA
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Zip | 70065-3510
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Country | US
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Telephone | 504-443-1294
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Fax | 504-443-1982
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Provider Business Mailing Address
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Address Line | 2124 38TH ST
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City | KENNER
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State | LA
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Zip | 70065-3510
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Country | US
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Telephone | 504-443-1294
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Fax | 504-443-1982
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN EDWARD BULL
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Credential | P.D.
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Telephone | 504-443-1294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 4086203001
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License Number State | LA
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