Provider Demographics
NPI:1881996700
Name:BURROUGHS, DAVID CLAUDE (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CLAUDE
Last Name:BURROUGHS
Suffix:
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 1:832 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2726
Mailing Address - Country:US
Mailing Address - Phone:864-681-0338
Mailing Address - Fax:
Practice Address - Street 1:501 N HARPER ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2337
Practice Address - Country:US
Practice Address - Phone:864-984-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist