Richard Fuller

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS19123 Issued in FL

Practice address

2899 N 12TH Ave
Pensacola, FL 32503-4001

Phone

(850) 438-7568

Fax

(850) 438-0683

NPI assigned

Sep 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• East Hill Pharmacy Inc

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1932275690
  NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1124635677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2899 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034001",
            "telephone_number": "850-438-7568",
            "fax_number": "850-438-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2899 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034001",
            "telephone_number": "850-438-7568",
            "fax_number": "850-438-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS19123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103526600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emilie L Fugate, APRN
• Alexa Fugina, MD
• Fuller Rehabilitation and Consulting Services, Inc.
• Abigail Fuller
• Audra Fuller, PA-C
• William R. Fullerton, RPH
• Ariana Fulton
• David Waring Fulton, D.C.
• Laura K Furiati
• Matthew Leland Furst, M.D.

• Pharmacist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.