Kenneth Lord Burgess, RPH
Individual provider Active NPI Pharmacist · Franklin, VA
NPI 1336409762 · NPPES record last updated May 18, 2012
Key facts
- NPI
- 1336409762
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202011980 (VA)
- Practice address
- 31370 Whistle Stop Dr
Franklin, VA 23851-3856 - Phone
- (757) 653-4154
- Fax
- (757) 569-6341
- NPI assigned
- May 18, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202011980 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202011980 | VA | Yes |
Addresses
Primary practice location
31370 Whistle Stop Dr
Franklin, VA 23851-3856
Mailing address
31370 Whistle Stop Dr
Franklin, VA 23851-3856
Phone (757) 653-4154
Other providers in Franklin, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.