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General NPI Number Information
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NPI Number | 1558390633
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Entity Type | Organization
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Legal Business Name | BURNS RX LLC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 270 MAIN ST
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City | MAMMOTH SPRING
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State | AR
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Zip | 72554-7466
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Country | US
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Telephone | 870-625-3222
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Fax | 870-625-3216
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | MAMMOTH SPRING
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State | AR
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Zip | 72554-0007
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Country | US
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Telephone | 870-625-3222
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Fax | 870-625-3216
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | SARAH CLARK
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Credential |
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Telephone | 870-625-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20278
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License Number State | AR
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