Provider Demographics
NPI:1881140127
Name:DUNLOP PHARMACY LLC
Entity type:Organization
Organization Name:DUNLOP PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RPH/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-299-4562
Mailing Address - Street 1:620 DUNLOP LANE
Mailing Address - Street 2:SUITE# 111
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5007
Mailing Address - Country:US
Mailing Address - Phone:931-278-6422
Mailing Address - Fax:931-278-6423
Practice Address - Street 1:620 DUNLOP LN STE # 111
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5000
Practice Address - Country:US
Practice Address - Phone:931-278-6422
Practice Address - Fax:931-278-6423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336S0011X
TN00000058353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2163877OtherPK