Healthcare Provider Details

I. General information

NPI: 1225102601
Provider Name (Legal Business Name): BURLING DRUG CO OF CORFU INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 E MAIN ST
CORFU NY
14036-9601
US

IV. Provider business mailing address

PO BOX 100
CORFU NY
14036-0100
US

V. Phone/Fax

Practice location:
  • Phone: 585-599-4563
  • Fax: 585-599-3394
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021199
License Number StateNY

VIII. Authorized Official

Name: DANIEL BURLING
Title or Position: OWNER
Credential: RPH
Phone: 585-599-4563