Provider Demographics
NPI:1912053109
Name:RDR CORPORATION
Entity Type:Organization
Organization Name:RDR CORPORATION
Other - Org Name:KESSLERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-841-6421
Mailing Address - Street 1:1152 EAST LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:TARRANT
Mailing Address - State:AL
Mailing Address - Zip Code:35217
Mailing Address - Country:US
Mailing Address - Phone:205-841-6421
Mailing Address - Fax:205-841-2405
Practice Address - Street 1:1152 EAST LAKE BLVD
Practice Address - Street 2:
Practice Address - City:TARRANT
Practice Address - State:AL
Practice Address - Zip Code:35217
Practice Address - Country:US
Practice Address - Phone:205-841-6421
Practice Address - Fax:205-841-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1058003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1260370001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #