Healthcare Provider Details

I. General information

NPI: 1700965845
Provider Name (Legal Business Name): BURNHAM-MCKINNEY PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 MAIN ST
MOSS POINT MS
39563-2738
US

IV. Provider business mailing address

PO BOX 8647
MOSS POINT MS
39562-0010
US

V. Phone/Fax

Practice location:
  • Phone: 228-475-3411
  • Fax: 228-471-1400
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number00774/01.1
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number00774/01.1
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number00774/01.1
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number077440/01.1
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number00774/01.1
License Number StateMS
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number00774/01.1
License Number StateMS
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number007741011
License Number StateMS

VIII. Authorized Official

Name: JOHN MCKINNEY
Title or Position: OWNER AND PRESIDENT
Credential: RPH
Phone: 228-475-3411