Provider Demographics
NPI:1720313943
Name:BURELLE, TIMOTHY NORMAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:NORMAN
Last Name:BURELLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-9519
Mailing Address - Country:US
Mailing Address - Phone:252-288-5078
Mailing Address - Fax:
Practice Address - Street 1:5053 HWY 70 W
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4503
Practice Address - Country:US
Practice Address - Phone:252-222-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist