Provider Demographics
NPI:1518630433
Name:ULI, THOMAS JOHN (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:ULI
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 W ACAPULCO LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3437
Mailing Address - Country:US
Mailing Address - Phone:623-533-7668
Mailing Address - Fax:
Practice Address - Street 1:15215 N COTTON LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-9607
Practice Address - Country:US
Practice Address - Phone:623-455-7902
Practice Address - Fax:623-455-7903
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist