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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