Provider Demographics
NPI:1194166413
Name:BURKYBILE, ANDREW COLLIN (PHARM D)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:COLLIN
Last Name:BURKYBILE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2067 MARIGOLD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-8853
Mailing Address - Country:US
Mailing Address - Phone:217-493-5506
Mailing Address - Fax:
Practice Address - Street 1:2067 MARIGOLD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-8853
Practice Address - Country:US
Practice Address - Phone:217-493-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013019542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist