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General NPI Number Information
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NPI Number | 1164960688
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Entity Type | Organization
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Legal Business Name | ANDERSON BURRIS INC
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 645 HARRISON ST
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City | HOPE
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State | IN
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Zip | 47246-1203
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Country | US
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Telephone | 812-287-8884
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Fax | 812-287-8921
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | BEDFORD
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State | IN
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Zip | 47421-0366
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Country | US
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Telephone | 812-546-2502
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Fax | 812-546-2336
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Authorized Official
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Title or Position | PRESIDENT
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Name | LESTER BURRIS
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Credential |
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Telephone | 812-546-2502
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60006601A
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License Number State | IN
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