Bullard Drug and Wellness
Organization Active NPI Pharmacy · Olla, LA
NPI 1417538422 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1417538422
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- BULLARD DRUG AND WELLNESS
- Practice address
- 3515 Main St. Hwy 165
Olla, LA 71465 - Phone
- (318) 495-1100
- NPI assigned
- Apr 20, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Ashley Alana Sanders Bullard, PHARMD
- Title
- Owner/Pharmacist in Charge
- Phone
- (318) 495-1100
Corporate family (same tax ID) 1
Practitioners 2
-
Ashley Bullard, PHARMD
-
Matthew Brent Bullard, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211223000470 | LA | Part B Supplier - Pharmacy | 0547651747 | Practice locations: Olla, LA |
| O20230609002533 | LA | DME Supplier - Pharmacy | 0547651747 | Practice locations: Olla, LA |
National Provider Directory
- Tax ID family
- Bullard Drug and Wellness
Locations
3515 Main Street 165
Olla, LA 71465
Phone (318) 495-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
3515 Main St. Hwy 165
Olla, LA 71465
Mailing address
3515 Main St. Hwy 165
Olla, LA 71465
Phone (318) 495-1100
Other names
- Bullard Drug and Wellness, LLC
Other providers in Olla, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.