Healthcare Provider Details

I. General information

NPI: 1245613603
Provider Name (Legal Business Name): ASHLEY BURKHAMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 07/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5989 MORGANTON RD
FAYETTEVILLE NC
28314-1353
US

IV. Provider business mailing address

4027 SOUTHERN OAKS DR UNIT 14
FAYETTEVILLE NC
28314-0988
US

V. Phone/Fax

Practice location:
  • Phone: 910-487-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25222
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: