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NPI Code Detail

MEDICARE: DR. TIMOTHY NORMAN BURELLE PHARM.D.

MEDICARE: DR. TIMOTHY NORMAN BURELLE PHARM.D.
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
1183500000XPharmacist20154NC

General Provider Information

NPI Number : 1720313943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY NORMAN BURELLE PHARM.D.
Provider Business Mailing Address
First Line : 268 SHORELINE DR
Second Line :
City : NEW BERN
State : NC
Zip : 28562-9519
Country : US
Telephone Number : 252-288-5078
Fax Number :
Provider Business Practice Location Address
First Line : 5053 HWY 70 W
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4503
Country : US
Telephone Number : 252-222-0288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2009
Last Update Date : 10/06/2009

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