Provider Demographics
NPI:1396842464
Name:HERBERT L BURKE, INC
Entity Type:Organization
Organization Name:HERBERT L BURKE, INC
Other - Org Name:BURKE'S DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:775-673-5000
Mailing Address - Street 1:5442 SUN VALLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-7657
Mailing Address - Country:US
Mailing Address - Phone:775-673-5000
Mailing Address - Fax:775-673-9365
Practice Address - Street 1:5442 SUN VALLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-7657
Practice Address - Country:US
Practice Address - Phone:775-673-5000
Practice Address - Fax:775-673-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH006593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3954060001Medicare ID - Type Unspecified