Healthcare Provider Details

I. General information

NPI: 1992042790
Provider Name (Legal Business Name): ERIC MATTHEW BURKE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 TONGASS AVE
KETCHIKAN AK
99901-5742
US

IV. Provider business mailing address

2960 TONGASS AVE
KETCHIKAN AK
99901-5742
US

V. Phone/Fax

Practice location:
  • Phone: 907-228-9205
  • Fax: 800-794-4025
Mailing address:
  • Phone: 907-228-9205
  • Fax: 800-794-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number016843
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1904
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: