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General NPI Number Information
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NPI Number | 1578589420
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Entity Type | Organization
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Legal Business Name | BURLE DRUGS LLC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 328 N MAIN ST
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City | LEWISBURG
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State | KY
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Zip | 42256-9213
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Country | US
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Telephone | 270-755-4831
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Fax | 270-755-4850
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Provider Business Mailing Address
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Address Line | 328 N MAIN ST P.O.BOX 300
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City | LEWISBURG
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State | KY
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Zip | 42256-9213
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Country | US
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Telephone | 270-755-4831
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Fax | 270-755-4850
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Authorized Official
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Title or Position | OWNER
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Name | SURESH BURLE
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Credential |
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Telephone | 270-755-4831
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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 | P07418
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License Number State | KY
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