Individual provider Active NPI

Mark Fulbright, RPH

  • Pharmacist
  • Cape Coral, FL
National Provider Identifier
1689968638
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS30736 Issued in FL
Practice address
2430 Santa Barbara Blvd
Cape Coral, FL 33914-4485
Phone
(239) 458-8570
Fax
(239) 458-8570
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS30736 FL Primary

Addresses

Primary practice location

2430 Santa Barbara Blvd
Cape Coral, FL 33914-4485

Mailing address

2430 Santa Barbara Blvd
Cape Coral, FL 33914-4485
Phone (239) 458-8570

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

LicenseStateTypeSpecialty
PS30736FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1689968638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144485",
            "telephone_number": "239-458-8570",
            "fax_number": "239-458-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144485",
            "telephone_number": "239-458-8570",
            "fax_number": "239-458-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULBRIGHT",
        "first_name": "MARK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS30736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.