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General NPI Number Information
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NPI Number | 1831964048
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Entity Type | Individual
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Provider Name | COLIN BURKE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 635 MAIN ST W
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City | RIPLEY
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State | WV
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Zip | 25271-1107
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Country | US
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Telephone | 304-372-7448
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Fax |
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Provider Business Mailing Address
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Address Line | 133 3RD AVE APT 3G
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25303-1460
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Country | US
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Telephone | 410-596-6348
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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 | RP0013941
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License Number State | WV
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