Provider Demographics
NPI:1326290784
Name:BURTON'S PHARMACY INC.
Entity Type:Organization
Organization Name:BURTON'S PHARMACY INC.
Other - Org Name:BURTON'S HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:336-272-7139
Mailing Address - Street 1:120 E LINDSAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3008
Mailing Address - Country:US
Mailing Address - Phone:336-272-7139
Mailing Address - Fax:336-272-4779
Practice Address - Street 1:120 E LINDSAY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-3008
Practice Address - Country:US
Practice Address - Phone:336-272-7139
Practice Address - Fax:336-272-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700218Medicaid
NC0416537Medicaid
NC0416537Medicaid