Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jack Edward Funderburk

Individual provider Pharmacist · NPI 1346530847

Mr. Jack Edward Funderburk is a Pharmacist in Moultrie, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
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Practice location Address checks out

305 6th St SE
Moultrie, GA 31768-4842
Phone: (229) 984-1378
Fax: (229) 890-3185
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence RPH010666 (GA)

Record details

NPI number1346530847
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 18, 2011
Last updated in NPPESApril 18, 2011

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