Provider Demographics
NPI:1942318621
Name:BURKE PHARMACY INC
Entity Type:Organization
Organization Name:BURKE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
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:
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:28655-3866
Mailing Address - Country:US
Mailing Address - Phone:
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:28655-3866
Practice Address - Country:US
Practice Address - Phone:828-437-8025
Practice Address - Fax:828-438-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5037332B00000X, 333600000X, 3336C0003X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0125393Medicaid
NC3417525OtherNABP
NC0125393Medicaid