Provider Demographics
NPI:1437910528
Name:BULL, JAMES WITTE JR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WITTE
Last Name:BULL
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 1:380 E 11TH AVE UNIT 324
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-6501
Mailing Address - Country:US
Mailing Address - Phone:843-908-5057
Mailing Address - Fax:
Practice Address - Street 1:2550 E 88TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3814
Practice Address - Country:US
Practice Address - Phone:907-349-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6360183500000X
AK213484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist