Provider Demographics
NPI:1447795984
Name:BURKE PHARMACY
Entity Type:Organization
Organization Name:BURKE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:IVEY
Authorized Official - Last Name:DUCKWORTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH BS
Authorized Official - Phone:828-437-0361
Mailing Address - Street 1:301 W MEETING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655
Mailing Address - Country:US
Mailing Address - Phone:828-437-0361
Mailing Address - Fax:828-438-8755
Practice Address - Street 1:301 W MEETING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-437-0361
Practice Address - Fax:828-438-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0151930001Medicare NSC
NC1841253528Medicare UPIN