Active NPI
Holly Burke, PHARMACIST
- Pharmacist
- D'Iberville, MS
National Provider Identifier
1225406648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E07308
- Practice address
- 3615 Sangani Blvd
Diberville, MS 39540-8770 - Phone
- (228) 396-4778
- Fax
- (228) 396-0129
- NPI assigned
- Sep 2, 2015
- Last updated
- Sep 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E07308 | MS | Primary |
Addresses
Primary practice location
3615 Sangani Blvd
Diberville, MS 39540-8770
Mailing address
3615 Sangani Blvd
Diberville, MS 39540-8770
Phone (228) 396-4778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E07308 | Other | MS | PHARMACY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E07308 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1225406648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 SANGANI BLVD",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395408770",
"telephone_number": "228-396-4778",
"fax_number": "228-396-0129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 SANGANI BLVD",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395408770",
"telephone_number": "228-396-4778",
"fax_number": "228-396-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "HOLLY",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E07308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "E07308",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in D'Iberville, MS
- Bio-Medical Applications of Mississippi, Inc. (South Mississippi Kidney Center (SMKC) - D'Iberville)
- Angela M Bowie, LCSW
- Andrea J Briscoe, PHARMD
- Jennifer G Brown, PHARMD
- Charis Buckland, LPC
- Rachel Strait Burt, PHARMD
- Melissa V Butler, LCSW
- Myra Marie Campbell, RPH
- Iesha Carroll, PHARMD
- Leslie Sue Chambers, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.