MEDICARE: BURNS PHARMACY, INC.

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
1	183500000X	Pharmacist	111830	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0102563	OTHER	AL	NABP

General Provider Information

NPI Number	:	1376636001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURNS PHARMACY, INC.

Provider Business Mailing Address
First Line	:	541 JACKSON BOULEVARD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217
Country	:	US
Telephone Number	:	205-841-6436
Fax Number	:	205-841-6432

Provider Business Practice Location Address
First Line	:	541 JACKSON BOULEVARD
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217
Country	:	US
Telephone Number	:	205-841-6436
Fax Number	:	205-841-6432

Authorized Official
Title or Position	:	OWNER / R.PH.
Name	:	MR. J. MICHAEL HOLLOWAY
Credential	:	R.PH.
Telephone Number	:	205-841-6436

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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Directions to “BURNS PHARMACY, INC. ” Practice Location

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