MEDICARE: MS. CATHARINE SUE BURNS R PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	012092	GA

General Provider Information

NPI Number	:	1083862809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHARINE SUE BURNS R PH

Provider Business Mailing Address
First Line	:	3640 MUNDY MILL RD
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-8218
Country	:	US
Telephone Number	:	770-532-9111
Fax Number	:

Provider Business Practice Location Address
First Line	:	3640 MUNDY MILL RD
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-8218
Country	:	US
Telephone Number	:	770-532-9111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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