Provider Demographics
NPI:1073236410
Name:CULP, JAMES BERNARD JR (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BERNARD
Last Name:CULP
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4533 HEMLOCK CONE WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5937
Mailing Address - Country:US
Mailing Address - Phone:410-461-3521
Mailing Address - Fax:
Practice Address - Street 1:4390 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6068
Practice Address - Country:US
Practice Address - Phone:410-203-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1195763OtherVACCINATION