Provider Demographics
NPI:1326589532
Name:BURKE, BETH D (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:D
Last Name:BURKE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ASHENFELTER RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2931
Mailing Address - Country:US
Mailing Address - Phone:610-933-0150
Mailing Address - Fax:
Practice Address - Street 1:209 ASHENFELTER RD
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-2931
Practice Address - Country:US
Practice Address - Phone:610-933-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040507L183500000X
PARPI008047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist