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NPI Code Detail

MEDICARE: MR. BRYAN KEITH BURKHOLDER RPH.

MEDICARE: MR. BRYAN KEITH BURKHOLDER RPH.
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
1183500000XPharmacist03314593OH

General Provider Information

NPI Number : 1356634752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN KEITH BURKHOLDER RPH.
Provider Business Mailing Address
First Line : 301 N MAIN ST
Second Line :
City : FINDLAY
State : OH
Zip : 45840-3503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N MAIN ST
Second Line :
City : FINDLAY
State : OH
Zip : 45840-3503
Country : US
Telephone Number : 419-420-9485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2011
Last Update Date : 05/18/2011

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Directions to “ MR. BRYAN KEITH BURKHOLDER RPH.” Practice Location

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