Provider Demographics
NPI:1316484769
Name:FULMORE, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:FULMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 SPIRAL LN
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:SC
Mailing Address - Zip Code:29541-4829
Mailing Address - Country:US
Mailing Address - Phone:843-230-4976
Mailing Address - Fax:
Practice Address - Street 1:1105 OLD EBENEZER RD APT E
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-8058
Practice Address - Country:US
Practice Address - Phone:843-230-4976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies