Provider Demographics
NPI:1952540494
Name:PULLINS, MOLLIE A (PHARMD,RPH)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:A
Last Name:PULLINS
Suffix:
Gender:F
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 KINGFISHER ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33621-5013
Mailing Address - Country:US
Mailing Address - Phone:813-828-2219
Mailing Address - Fax:
Practice Address - Street 1:7101 KINGFISHER ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33621-5013
Practice Address - Country:US
Practice Address - Phone:813-828-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS411961835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist