Provider Demographics
NPI:1598275372
Name:JULIAN, BOBOBIE JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:BOBOBIE JO
Middle Name:
Last Name:JULIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3351
Mailing Address - Country:US
Mailing Address - Phone:304-224-8378
Mailing Address - Fax:
Practice Address - Street 1:1600 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOLLANSBEE
Practice Address - State:WV
Practice Address - Zip Code:26037-1259
Practice Address - Country:US
Practice Address - Phone:304-527-4082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist