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Organization
BURKE CENTER
Active
Organization
BURKE CENTER
Active
Other names
East Texas Behavioral Healthcare Network Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TED ZIESCHANG RPH (DIRECTOR OF PHARMACY)
(936) 634-5664
Entity
Organization
Contact information
Practice address
2704 HOMER ALTO RD, LUFKIN, TX 75904-8750
(800) 564-6701
(800) 564-7591
Mailing address
2704 HOMER ALTO RD, LUFKIN, TX 75904-8750
(800) 564-6701
(800) 564-7591
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
22928
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145375
—
TX
01
—
2096453
PK
—
Enumeration date
10/05/2006
Last updated
04/30/2019
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