Provider Demographics
NPI:1679163943
Name:BURNHAM MCKINNEY PHARMACIES INC
Entity type:Organization
Organization Name:BURNHAM MCKINNEY PHARMACIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-474-4663
Mailing Address - Street 1:4931 MAIN ST # B
Mailing Address - Street 2:
Mailing Address - City:MOSS POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39563-2746
Mailing Address - Country:US
Mailing Address - Phone:228-474-4663
Mailing Address - Fax:228-474-5545
Practice Address - Street 1:4931 MAIN ST # B
Practice Address - Street 2:
Practice Address - City:MOSS POINT
Practice Address - State:MS
Practice Address - Zip Code:39563-2746
Practice Address - Country:US
Practice Address - Phone:228-474-4663
Practice Address - Fax:228-474-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy