Provider Demographics
NPI:1144945924
Name:BURGER, BARBARA ANN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:BURGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5414
Mailing Address - Country:US
Mailing Address - Phone:937-432-8200
Mailing Address - Fax:
Practice Address - Street 1:1410 E DOROTHY LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3806
Practice Address - Country:US
Practice Address - Phone:937-294-0535
Practice Address - Fax:937-294-6282
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03218063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist