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General NPI Number Information
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NPI Number | 1982885000
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Entity Type | Individual
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Provider Name | CYNTHIA BURCK RPH
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Gender | Female
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1720 UNIVERSITY DR S TRIUMPH
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City | FARGO
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State | ND
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Zip | 58103
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Country | US
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Telephone | 701-241-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 RIVER DR S
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City | FARGO
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State | ND
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Zip | 58104-6420
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Country | US
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Telephone | 701-232-3800
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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 | 3857
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License Number State | ND
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