Provider Demographics
NPI:1902069628
Name:BULLOCK, KATURA CELESTE (PHARMD, BCPS, BCAC)
Entity type:Individual
Prefix:DR
First Name:KATURA
Middle Name:CELESTE
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:PHARMD, BCPS, BCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2017
Mailing Address - Country:US
Mailing Address - Phone:484-626-1216
Mailing Address - Fax:
Practice Address - Street 1:3440 LEHIGH ST STE 102
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7001
Practice Address - Country:US
Practice Address - Phone:484-658-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX465681835P1200X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy