Provider Demographics
NPI:1891565065
Name:BURRYS PHARMACY, INC.
Entity Type:Organization
Organization Name:BURRYS PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:BURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-787-3787
Mailing Address - Street 1:500 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5019
Mailing Address - Country:US
Mailing Address - Phone:352-787-3787
Mailing Address - Fax:352-787-3787
Practice Address - Street 1:500 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5019
Practice Address - Country:US
Practice Address - Phone:352-787-3787
Practice Address - Fax:352-787-3787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURRY'S PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy