Healthcare Provider Details

I. General information

NPI: 1356109292
Provider Name (Legal Business Name): AUSTIN JAMES BURKHART PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 FOREST DR
COLUMBIA SC
29206-5401
US

IV. Provider business mailing address

5420 FOREST DR
COLUMBIA SC
29206-5401
US

V. Phone/Fax

Practice location:
  • Phone: 803-782-8428
  • Fax: 803-782-1726
Mailing address:
  • Phone: 803-782-8428
  • Fax: 803-782-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32878
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67714
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: