Provider Demographics
NPI:1437171261
Name:BURNS DRUG COMPANY
Entity Type:Organization
Organization Name:BURNS DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-628-6300
Mailing Address - Street 1:135 PITTSBURGH ST.
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1732
Mailing Address - Country:US
Mailing Address - Phone:724-887-6300
Mailing Address - Fax:724-887-4337
Practice Address - Street 1:135 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1732
Practice Address - Country:US
Practice Address - Phone:724-887-6300
Practice Address - Fax:724-887-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PAPP410308L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007477320003Medicaid
PA3914125OtherNABP
PA0438790003Medicare NSC
PA1007477320003Medicaid