MEDICARE: RDR CORPORATION

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	3336C0003X	Community/Retail Pharmacy	105800	AL

General Provider Information

NPI Number	:	1912053109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RDR CORPORATION

Provider Business Mailing Address
First Line	:	1152 EAST LAKE BLVD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217
Country	:	US
Telephone Number	:	205-841-6421
Fax Number	:	205-841-2405

Provider Business Practice Location Address
First Line	:	1152 EAST LAKE BLVD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217
Country	:	US
Telephone Number	:	205-841-6421
Fax Number	:	205-841-2405

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ROBERT MICHAEL BURNS
Credential	:	RPH
Telephone Number	:	205-841-6421

Provider Enumeration Date	:	01/28/2007
Last Update Date	:	10/17/2023

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