Robert Milton Burdett Jr., RPH. – Pharmacist

Key facts

NPI: 1922064039
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 2435 (WY)
Practice address: 2360 E Pershing Blvd
Pharmacy (119)
Cheyenne, WY 82001-5356
Phone: (307) 778-7550
Fax: (307) 778-7588
NPI assigned: Apr 26, 2006
Sex: Male
Sole proprietor: Yes

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
2435	WY	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	2435	WY	Yes

Addresses

Primary practice location

2360 E Pershing Blvd
Pharmacy (119)
Cheyenne, WY 82001-5356

Mailing address

2360 E Pershing Blvd
Pharmacy (119)
Cheyenne, WY 82001-5356
Phone (307) 778-7550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 11, 2007.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1922064039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "address_2": "PHARMACY (119)",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550",
            "fax_number": "307-778-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "address_2": "PHARMACY (119)",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550",
            "fax_number": "307-778-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDETT",
        "first_name": "ROBERT",
        "middle_name": "MILTON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "2435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

All providers in Cheyenne, WY · Pharmacist in Wyoming

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. 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.

Verify at the official NPI Registry.