Provider Demographics
NPI:1437229002
Name:BURNS, MARIE FEGHALI (RPH)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:FEGHALI
Last Name:BURNS
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 1:1106 GREGG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3825
Mailing Address - Country:US
Mailing Address - Phone:803-758-6013
Mailing Address - Fax:803-758-6013
Practice Address - Street 1:1308 LAUREL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2514
Practice Address - Country:US
Practice Address - Phone:803-931-8123
Practice Address - Fax:803-931-8201
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91401835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric