# BURNHAM-MCKINNEY PHARMACY NO 4 LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215018064
- **Authorized official:** MR. JOHN A. MCKINNEY R.PH. (OWNER)
- **Authorized official phone:** (228) 826-4747

## Contact information

- **Practice address:** 12500 HIGHWAY 57, VANCLEAVE, MS 39565-9614
- **Practice address phone:** (228) 826-4747
- **Practice address fax:** (228) 826-2156
- **Mailing address:** 12500 HIGHWAY 57, VANCLEAVE, MS 39565-9614
- **Mailing address phone:** (228) 826-4747
- **Mailing address fax:** (228) 826-2156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 08/26/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0330586 | — | MS |