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NPI Code Detail

MEDICARE: MRS. TINA ALEXANDER BULLARD RPH

MEDICARE: MRS. TINA ALEXANDER BULLARD 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
1183500000XPharmacist07754NC

General Provider Information

NPI Number : 1801872163
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TINA ALEXANDER BULLARD RPH
Provider Business Mailing Address
First Line : 3 TRINITY DR
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-8333
Country : US
Telephone Number : 910-671-5719
Fax Number : 910-671-5709
Provider Business Practice Location Address
First Line : 1150 PINE RUN DR
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-2118
Country : US
Telephone Number : 910-671-5719
Fax Number : 910-671-5709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 07/08/2007

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