Provider Demographics
NPI:1013074970
Name:BULLARD, RICHARD H (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:H
Last Name:BULLARD
Suffix:
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 1:1650 W GRISWOLD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5435
Mailing Address - Country:US
Mailing Address - Phone:602-371-0085
Mailing Address - Fax:602-371-0085
Practice Address - Street 1:15950 NORTH 76TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1884
Practice Address - Country:US
Practice Address - Phone:480-624-9265
Practice Address - Fax:480-624-9401
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist