Provider Demographics
NPI:1669553814
Name:HULL, RYAN PHILLIP (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PHILLIP
Last Name:HULL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 ELLIS HOYLE RD
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:NC
Mailing Address - Zip Code:28168-8445
Mailing Address - Country:US
Mailing Address - Phone:704-276-9198
Mailing Address - Fax:
Practice Address - Street 1:9576 NC HWY 10W
Practice Address - Street 2:THE DRUG STORE HEALTH MART #2
Practice Address - City:VALE
Practice Address - State:NC
Practice Address - Zip Code:28168
Practice Address - Country:US
Practice Address - Phone:704-462-0226
Practice Address - Fax:704-462-0229
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist