Provider Demographics
NPI:1164478830
Name:BUR-KIE, INC
Entity Type:Organization
Organization Name:BUR-KIE, INC
Other - Org Name:BURKE'S DRUG GREENBRAE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:MACKIE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:775-356-3500
Mailing Address - Street 1:544 GREENBRAE DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3137
Mailing Address - Country:US
Mailing Address - Phone:775-356-3500
Mailing Address - Fax:775-356-3550
Practice Address - Street 1:544 GREENBRAE DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3137
Practice Address - Country:US
Practice Address - Phone:775-356-3500
Practice Address - Fax:775-356-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH020563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2989892OtherNCPDP#
2989892OtherNCPDP#