MEDICARE: JOE BURNS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	19988	AL

General Provider Information

NPI Number	:	1114517232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE BURNS PHARMD

Provider Business Mailing Address
First Line	:	1152 E LAKE BLVD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217-2402
Country	:	US
Telephone Number	:	205-841-6421
Fax Number	:

Provider Business Practice Location Address
First Line	:	1152 E LAKE BLVD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217-2402
Country	:	US
Telephone Number	:	205-841-6421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	01/22/2021

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Directions to “ JOE BURNS PHARMD” Practice Location

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