MEDICARE: BULLARD HOME INFUSION INC

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
1	3336H0001X	Home Infusion Therapy Pharmacy	15638	TX

General Provider Information

NPI Number	:	1417050303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULLARD HOME INFUSION INC

Provider Business Mailing Address
First Line	:	1926 W MORTON
Second Line	:	SUITE B
City	:	DENISON
State	:	TX
Zip	:	75020-1617
Country	:	US
Telephone Number	:	903-465-0214
Fax Number	:	903-465-3492

Provider Business Practice Location Address
First Line	:	1926 W MORTON
Second Line	:	SUITE B
City	:	DENISON
State	:	TX
Zip	:	75020-1617
Country	:	US
Telephone Number	:	903-465-0214
Fax Number	:	903-465-3492

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN D BULLARD
Credential	:	RPH
Telephone Number	:	903-465-0214

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	12/05/2007

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