Provider Demographics
NPI:1922381821
Name:BURCKART, RAYMOND EDWARD III (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:EDWARD
Last Name:BURCKART
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 MOUNT HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3123
Mailing Address - Country:US
Mailing Address - Phone:724-699-9461
Mailing Address - Fax:
Practice Address - Street 1:900 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3336
Practice Address - Country:US
Practice Address - Phone:724-342-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037949L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist