Yvette Bull

Individual provider Active NPI Pharmacist · Santee, SC

NPI 1124577796 · NPPES record last updated Sep 23, 2016

Key facts

NPI
1124577796
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7613 (SC)
Practice address
240 Planters Trace Rd
Santee, SC 29142-9274
Phone
(803) 854-2417
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7613SCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Pharmacist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7613 SC Yes

Addresses

Primary practice location

240 Planters Trace Rd
Santee, SC 29142-9274

Mailing address

240 Planters Trace Rd
Santee, SC 29142-9274

Other providers in Santee, SC

All providers in Santee, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.