Pultorak, Kevin Paul

Pultorak, Kevin Paul is an individual health care provider with primary practice located at 6610 Old Monroe Rd , Indian Trail NC 28079-5351. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Pultorak, Kevin Paul can be contacted via phone (704) 289-1193.

Contact Information

Primary practice address
6610 Old Monroe Rd Indian Trail NC 28079-5351
Phone: (704) 289-1193
Fax: (704) 289-1662
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 12512 North Carolina

Profile Details

NPI number 1093007601
LBN Legal business name Pultorak, Kevin Paul
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2011
Last updated May 15th, 2011 - about 15 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 1093007601 NPPES
North Carolina MEDICAID 0905555

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