Funderburk, Jack Edward

Funderburk, Jack Edward is an individual health care provider with primary practice located at 305 6Th St Se , Moultrie GA 31768-4842. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Funderburk, Jack Edward can be contacted via phone (229) 984-1378.

Contact Information

Primary practice address
305 6Th St Se Moultrie GA 31768-4842
Phone: (229) 984-1378
Fax: (229) 890-3185
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X RPH010666 Georgia

Profile Details

NPI number 1346530847
LBN Legal business name Funderburk, Jack Edward
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2011
Last updated Apr 18th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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