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NPI Code Detail

MEDICARE: MICHAEL PAUL FULGHUM RPH

MEDICARE: MICHAEL PAUL FULGHUM RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS34183FL

General Provider Information

NPI Number : 1326385006
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PAUL FULGHUM RPH
Provider Business Mailing Address
First Line : 650 W 23RD ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3921
Country : US
Telephone Number : 850-747-9786
Fax Number : 850-747-3260
Provider Business Practice Location Address
First Line : 650 W 23RD ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3921
Country : US
Telephone Number : 850-747-9786
Fax Number : 850-747-3260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2013
Last Update Date : 01/14/2013

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