Healthcare Provider Details

I. General information

NPI: 1518032499
Provider Name (Legal Business Name): DAVID P BURKE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MAIN ST
HILTON HEAD ISLAND SC
29926-1624
US

IV. Provider business mailing address

69 WEDGEFIELD DR
HILTON HEAD ISLAND SC
29926-2243
US

V. Phone/Fax

Practice location:
  • Phone: 843-681-2622
  • Fax: 843-681-9392
Mailing address:
  • Phone: 843-681-2622
  • Fax: 843-681-9392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6361
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: