Provider Demographics
NPI:1407431984
Name:MULLINS, RICK L (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:L
Last Name:MULLINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-1406
Mailing Address - Country:US
Mailing Address - Phone:276-328-9141
Mailing Address - Fax:276-328-9130
Practice Address - Street 1:301 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-5629
Practice Address - Country:US
Practice Address - Phone:276-328-9141
Practice Address - Fax:276-328-9130
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist