Bullen, Jack Edward

Bullen, Jack Edward is an individual health care provider with primary practice located at 239 W Summer St , Greeneville TN 37743-4925. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Bullen, Jack Edward can be contacted via phone (423) 638-4711.

Contact Information

Primary practice address
239 W Summer St Greeneville TN 37743-4925
Phone: (423) 638-4711
Fax: (423) 638-3311
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 458 Tennessee

Profile Details

NPI number 1912042094
LBN Legal business name Bullen, Jack Edward
Credentials Doctor of Public Health (DPH)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912042094 NPPES
Tennessee MEDICAID 1454403

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