Healthcare Provider Details

I. General information

NPI: 1952591877
Provider Name (Legal Business Name): BMC LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603B HIGHWAY 365
BURNSVILLE MS
38833
US

IV. Provider business mailing address

PO BOX 307
BURNSVILLE MS
38833-0307
US

V. Phone/Fax

Practice location:
  • Phone: 662-427-9977
  • Fax: 662-427-8877
Mailing address:
  • Phone: 662-427-9977
  • Fax: 662-427-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN FRANKLIN BURNS
Title or Position: PRESIDENT
Credential: RPH
Phone: 662-423-3628