Provider Demographics
NPI:1639852569
Name:BURCH, BRITTANY (RPH)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BURCH
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 1:6285 W CHOCTAW CT
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-6620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5485 SUN VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-7633
Practice Address - Country:US
Practice Address - Phone:775-674-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist