Burnham Drugs No. 4 LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

BURNHAM DRUGS NO. 4 LLC

Practice address

12500 Highway 57
Vancleave, MS 39565-9614

Phone

(228) 826-2156

Fax

(228) 826-2156

NPI assigned

Aug 16, 2024

Last updated

Aug 16, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BURNHAM DRUGS NO. 4 MOTAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandy L Lucas

Title

Manager

Phone

(228) 475-3411

Specialties & licenses 1

Addresses

Other names 1

• Burnham Drugs No. 4 MOT Other name

Tax ID family

Burnham Drugs No 4 LLC2 organizations share this tax ID, including this one

Part of

Burnham Drugs No 4 LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Burnham-McKinney Pharmacy No 4 LLC

  • Community/Retail Pharmacy
  • Vancleave, MS
  • NPI 1215018064
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1245062405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8647",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395620010",
            "telephone_number": "228-475-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 HIGHWAY 57",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395659614",
            "telephone_number": "228-826-2156",
            "fax_number": "228-826-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNHAM DRUGS NO. 4 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BURNHAM DRUGS NO. 4 MOT",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "228-475-3411"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burnham Drugs No. 4 MOT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lennon E. Bowen IV, M.D.
• Elizabeth Louise Boyle, MS, LPC
• Shana Marie Broussard
• Sarah Burke
• Christopher Burks, MD
• Burnham-McKinney Pharmacy No 4 LLC
• Karen Veronica Carlisle-Bond, FNP-C
• Jake Wallace Carzoli, FNP-C
• Leigh Chiasson
• Karley Clark, APRN, MSN, FNP-C

• Long Term Care Pharmacy in Vancleave, MS
• Providers in Vancleave, MS by specialty
• Long Term Care Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.