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SUSAN BURGESS

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1003406166

Individual Registrant:
 SUSAN  BURGESS 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1058 MAIN ST  FORTUNA, CA 95540-2009 US
Tel: 707-725-3040  Fax: 707-726-2671

Contact information for business:
1058 MAIN ST  FORTUNA, CA 95540-2009 US
Tel: 707-725-3040  Fax: --

Registration Information:
NPI: 1003406166
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CA58285

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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