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General NPI Number Information
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NPI Number | 1669754503
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Entity Type | Individual
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Provider Name | BRIAN K BURCHELL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 6016 SHALLOWFORD RD SUITE 1300
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7225
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Country | US
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Telephone | 423-899-3690
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Fax |
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Provider Business Mailing Address
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Address Line | 204 CROMWELL CIR NW
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City | CLEVELAND
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State | TN
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Zip | 37312-4276
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Country | US
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Telephone | 865-206-3961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9824
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH024590
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License Number State | GA
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