Healthcare Provider Details

I. General information

NPI: 1003991977
Provider Name (Legal Business Name): BURNHAM-MCKINNEY PHARMACIES, INC. #2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7709 HIGHWAY 613
MOSS POINT MS
39562
US

IV. Provider business mailing address

PO BOX 722
ESCATAWPA MS
39552-0722
US

V. Phone/Fax

Practice location:
  • Phone: 228-475-3909
  • Fax: 228-475-3903
Mailing address:
  • Phone: 228-475-3909
  • Fax: 228-475-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN A. MCKINNEY
Title or Position: OWNER/PRESIDENT
Credential: R.PH.
Phone: 228-475-3411