Provider Demographics
NPI:1659739605
Name:HURST, JULIE (RPH)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WILKINS WISE RD
Mailing Address - Street 2:SUITE 38
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402 WILKINS WISE RD
Practice Address - Street 2:SUITE 38
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1725
Practice Address - Country:US
Practice Address - Phone:866-279-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE7332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist