Provider Demographics
NPI:1023366184
Name:PULLEY, DONALD JOSEPH JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOSEPH
Last Name:PULLEY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 WINDING RIVER LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-6526
Mailing Address - Country:US
Mailing Address - Phone:864-329-0090
Mailing Address - Fax:
Practice Address - Street 1:3518 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7553
Practice Address - Country:US
Practice Address - Phone:864-220-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11147183500000X
PARP036113L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist