Provider Demographics
NPI:1225121825
Name:BURGESS, JENNIFER PRICE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PRICE
Last Name:BURGESS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 NORTH ROAD ST
Mailing Address - Street 2:ALBEMARLE HOSPITAL PHARMACY
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-384-4038
Mailing Address - Fax:252-384-4800
Practice Address - Street 1:1144 NORTH ROAD ST
Practice Address - Street 2:ALBEMARLE HOSPITAL PHARMACY
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-384-4038
Practice Address - Fax:252-384-4800
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist