Organization
BURKE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VAN TRUMAN CLONTZ CFTS0032 (OWNER/TECH)
(828) 437-5800
Entity
Organization
Contact information
Practice address
301 WEST MEETING STREET, MORGANTON, NC 28655-3688
(828) 437-5800
(828) 438-8755
Mailing address
301 W MEETING ST, MORGANTON, NC 28655-3866
(828) 437-5800
(828) 437-8755
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
5037
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795318
—
NC
Enumeration date
10/08/2010
Last updated
10/08/2010
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