Active NPI
Barbara Mandulak
- Pharmacist
- Fort Bragg, NC
National Provider Identifier
1043974124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7717
- Practice address
- 4861 Logistics Avenue
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-6695
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 7717 | NC | Primary |
Addresses
Primary practice location
4861 Logistics Avenue
Fort Bragg, NC 28310-0001
Mailing address
5830 Arbutus TRL
Fayetteville, NC 28311-1428
Phone (910) 488-5474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000004735104 | Other | NC | NC DRIVERS LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | barbara.l.mandulk.civ@mail.mil | Direct | |
| Direct Messaging Address | barbara.l.mandulak.civ@mail.mil |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1043974124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5830 ARBUTUS TRL",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111428",
"telephone_number": "910-488-5474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4861 LOGISTICS AVENUE",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-6695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDULAK",
"first_name": "BARBARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "7717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC DRIVERS LICENSE",
"identifier": "000004735104",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "barbara.l.mandulk.civ@mail.mil",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "other",
"address_1": "4861 Logistics Avenue",
"city": "Fort Bragg",
"state": "NC",
"country_code": "US",
"postal_code": "283100001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "barbara.l.mandulak.civ@mail.mil",
"affiliation": "N",
"address_1": "4861 Logistics Avenue",
"city": "Fort Bragg",
"state": "NC",
"country_code": "US",
"postal_code": "283100001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.