Active NPI
Thomas Kelton Bullock Jr., RPH
- Pharmacist
- Foley, AL
National Provider Identifier
1366706186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17582
- Practice address
- 703 N McKenzie St
Foley, AL 36535-3542 - Phone
- (251) 200-5750
- Fax
- (251) 200-5725
- NPI assigned
- Jun 26, 2012
- Last updated
- Jan 17, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | D07327 | MS | |
| Pharmacist | 183500000X | 17582 | AL | Primary |
Addresses
Primary practice location
703 N McKenzie St
Foley, AL 36535-3542
Mailing address
10097 Grove Dr
Fairhope, AL 36532-5777
Phone (228) 216-2501
Other practice location 1
348 Highway 90
Waveland, MS 39576-2672
Phone (228) 467-4436
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17582 | AL | MD | Pharmacist |
| D07327 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foley Pharmacy | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
703 N McKenzie St
Foley, AL 36535
Phone (251) 200-5720
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pharmacy
- Foley, AL
- NPI 1275303984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1366706186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10097 GROVE DR",
"city": "FAIRHOPE",
"state": "AL",
"postal_code": "365325777",
"telephone_number": "228-216-2501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 N MCKENZIE ST",
"city": "FOLEY",
"state": "AL",
"postal_code": "365353542",
"telephone_number": "251-200-5750",
"fax_number": "251-200-5725"
}
],
"practiceLocations": [
{
"address_1": "348 Highway 90",
"address_purpose": "LOCATION",
"city": "Waveland",
"state": "MS",
"postal_code": "395762672",
"country_code": "US",
"telephone_number": "228-467-4436",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLOCK",
"first_name": "THOMAS",
"middle_name": "KELTON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "D07327",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "17582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Foley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.