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General NPI Number Information
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NPI Number | 1104987924
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Entity Type | Organization
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Legal Business Name | BURHENNS PHARMACY INC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 861 E 38TH ST
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City | ERIE
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State | PA
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Zip | 16504-1768
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Country | US
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Telephone | 814-824-8224
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Fax | 814-824-8229
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Provider Business Mailing Address
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Address Line | 861 E 38TH ST
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City | ERIE
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State | PA
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Zip | 16504-1768
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Country | US
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Telephone | 814-824-8224
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Fax | 814-824-8229
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHAEL BURHENN
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Credential | R.PH
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Telephone | 814-824-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP410299L
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License Number State | PA
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