Healthcare Provider Details

I. General information

NPI: 1396978391
Provider Name (Legal Business Name): BURKE COMMUNITY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 NORTH MAIN ST, SUITE #2
PRESHO SD
57568
US

IV. Provider business mailing address

PO BOX 158 116 NORTH MAIN ST, SUITE #2
PRESHO SD
57568
US

V. Phone/Fax

Practice location:
  • Phone: 605-895-6337
  • Fax: 605-895-6338
Mailing address:
  • Phone: 605-895-6337
  • Fax: 605-895-6338

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 Number100-1952
License Number StateSD

VIII. Authorized Official

Name: RENEE SUTTON
Title or Position: PHARMACIST IN CHARGE
Credential: RPH
Phone: 605-775-2294