Provider Demographics
NPI:1205672581
Name:BULLOCK, BRITTANY RAE (PHARMD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RAE
Last Name:BULLOCK
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 HAMPTON FOREST DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7727
Mailing Address - Country:US
Mailing Address - Phone:563-940-9401
Mailing Address - Fax:
Practice Address - Street 1:740 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4336
Practice Address - Country:US
Practice Address - Phone:704-784-9613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist