Provider Demographics
NPI:1558951384
Name:THE BURWELL CORP.,LLC
Entity Type:Organization
Organization Name:THE BURWELL CORP.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BURWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-207-8362
Mailing Address - Street 1:19905 W CATAWBA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4037
Mailing Address - Country:US
Mailing Address - Phone:704-909-7958
Mailing Address - Fax:
Practice Address - Street 1:19905 W CATAWBA AVE STE 201
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4037
Practice Address - Country:US
Practice Address - Phone:973-207-8362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care