Provider Demographics
NPI:1114684438
Name:BURTON PHARMACY LLC
Entity Type:Organization
Organization Name:BURTON PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-888-8004
Mailing Address - Street 1:3020 EAST ATHERTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48529
Mailing Address - Country:US
Mailing Address - Phone:810-888-8004
Mailing Address - Fax:810-888-8005
Practice Address - Street 1:3020 EAST ATHERTON ROAD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529
Practice Address - Country:US
Practice Address - Phone:810-888-8004
Practice Address - Fax:810-888-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy