Provider Demographics
NPI:1669811394
Name:BURBACH, JOY LYNN (RPH)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:LYNN
Last Name:BURBACH
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 1:1311 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3101
Mailing Address - Country:US
Mailing Address - Phone:406-259-7034
Mailing Address - Fax:406-259-7398
Practice Address - Street 1:1311 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3101
Practice Address - Country:US
Practice Address - Phone:406-259-7034
Practice Address - Fax:406-259-7398
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2013-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-5977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist