Active NPI
Julie Udulutch, RPH
- Pharmacist
- Waupaca, WI
National Provider Identifier
1679859946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11269-40
- Practice address
- 800 Riverside Dr
Waupaca, WI 54981-1943 - Phone
- (715) 256-1115
- Fax
- (715) 256-1105
- NPI assigned
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11269-40 | WI | Primary |
Addresses
Primary practice location
800 Riverside Dr
Waupaca, WI 54981-1943
Mailing address
1584 S Ponderosa Dr
Stevens Point, WI 54482-8635
Phone (715) 544-4323
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 |
|---|---|---|---|
| 11269-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1679859946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1584 S PONDEROSA DR",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544828635",
"telephone_number": "715-544-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 RIVERSIDE DR",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549811943",
"telephone_number": "715-256-1115",
"fax_number": "715-256-1105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDULUTCH",
"first_name": "JULIE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11269-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupaca, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.