Bryan Richard Bullock, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI04201500 Issued in NJ

Practice address

811 Fischer Blvd
Toms River, NJ 08753-4605

Phone

(732) 929-3440

Fax

(732) 929-0920

NPI assigned

Mar 1, 2021

Last updated

Sep 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Rite Aid of Pennsylvania LLC

  dba Rite Aid Pharmacy 02248

  • Community/Retail Pharmacy
  • Lake Ariel, PA
  • NPI 1780774802
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1417541574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 KILKORMIC ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533148",
            "telephone_number": "732-703-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 FISCHER BLVD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087534605",
            "telephone_number": "732-929-3440",
            "fax_number": "732-929-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "BRYAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04201500",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "PI121714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Haley Renee Bulwin, LAC
• Quin West Buob
• Jennifer Lynn Burdo, PA-C
• Brittany Buresch, APN
• Janine Marie Burgio

• Pharmacist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.