Provider Demographics
NPI:1154851996
Name:BURGER, CODY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:
Last Name:BURGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7116 PINE SEED DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-6319
Mailing Address - Country:US
Mailing Address - Phone:813-484-3206
Mailing Address - Fax:
Practice Address - Street 1:710 CENTER STREET
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-571-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHI-017043183500000X
GARPH0299881835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist