Active NPI
Brian Tullis
- Pharmacist
- Orem, UT
National Provider Identifier
1013369602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5668530-1701
- Practice address
- 774 S State St
Orem, UT 84058-6308 - Phone
- (801) 426-6650
- NPI assigned
- Jul 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5668530-1701 | UT | Primary |
Addresses
Primary practice location
774 S State St
Orem, UT 84058-6308
Mailing address
11976 S Woodridge Rd
Sandy, UT 84094-5723
Phone (801) 856-7155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5668530-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1013369602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11976 S WOODRIDGE RD",
"city": "SANDY",
"state": "UT",
"postal_code": "840945723",
"telephone_number": "801-856-7155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "774 S STATE ST",
"city": "OREM",
"state": "UT",
"postal_code": "840586308",
"telephone_number": "801-426-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLIS",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-07",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "5668530-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.