Provider Demographics
NPI:1477948719
Name:BULICH, NEIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:BULICH
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 1:144 BARTON DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475-3418
Mailing Address - Country:US
Mailing Address - Phone:717-291-8267
Mailing Address - Fax:
Practice Address - Street 1:144 BARTON DR
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-3418
Practice Address - Country:US
Practice Address - Phone:717-291-8267
Practice Address - Fax:717-291-8069
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARH 046325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist