Rodney Burris, PHARMD
Individual provider Active NPI Pharmacist · Clayton, GA
NPI 1861980369 · NPPES record last updated Apr 30, 2018
Key facts
- NPI
- 1861980369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH029655 (GA)
- Practice address
- 162 Legacy PT
Clayton, GA 30525-5354 - Phone
- (706) 782-3100
- NPI assigned
- Apr 30, 2018
- 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH029655 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH029655 | GA | Yes |
Addresses
Primary practice location
162 Legacy PT
Clayton, GA 30525-5354
Mailing address
162 Legacy PT
Clayton, GA 30525-5354
Phone (706) 782-3100
Other providers in Clayton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2018. 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.