Provider Demographics
NPI:1245486299
Name:BULLINGTON, KURT GARY (RPH)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:GARY
Last Name:BULLINGTON
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:CMR 402
Mailing Address - Street 2:BOX 1619
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:011490637-186-7570
Mailing Address - Fax:01149637-186-7266
Practice Address - Street 1:CMR 402 BOX 1619
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-1619
Practice Address - Country:US
Practice Address - Phone:01149637-186-7570
Practice Address - Fax:01149637-186-7266
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP-4510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist