Individual provider Active NPI

Robert John Boulier III, PHARMD

  • Pharmacist
  • Hill AFB, UT
National Provider Identifier
1093983900
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR5504 Issued in ME
Practice address
7321 11TH St
BLDG 570
Hill AFB, UT 84056-5012
Phone
(801) 586-9534
Fax
(801) 586-9890
NPI assigned
Feb 13, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR5504 ME Primary

Addresses

Primary practice location

7321 11TH St
BLDG 570
Hill AFB, UT 84056-5012

Mailing address

7321 11TH St
BLDG 570
Hill AFB, UT 84056-5012
Phone (801) 586-9534

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PR5504MEMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1093983900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7321 11TH ST",
            "address_2": "BLDG 570",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "840565012",
            "telephone_number": "801-586-9534",
            "fax_number": "801-586-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7321 11TH ST",
            "address_2": "BLDG 570",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "840565012",
            "telephone_number": "801-586-9534",
            "fax_number": "801-586-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULIER",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hill AFB, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.