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NPI Code Detail

MEDICARE: MARLEY BURNS

MEDICARE: MARLEY BURNS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistE-11695MS

General Provider Information

NPI Number : 1063782480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLEY BURNS
Provider Business Mailing Address
First Line : 64 BURNS RD
Second Line :
City : UNION
State : MS
Zip : 39365-8236
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1005 W BEACON ST
Second Line :
City : PHILADELPHIA
State : MS
Zip : 39350-3203
Country : US
Telephone Number : 601-389-1119
Fax Number : 601-389-9902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2012
Last Update Date : 01/02/2012

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Directions to “ MARLEY BURNS ” Practice Location

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