# BURNHAM DRUGS NO. 4 LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BURNHAM DRUGS NO. 4 MOT
- **Other names:** Burnham Drugs No. 4 MOT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245062405
- **Legal business name:** BURNHAM DRUGS NO. 4 MOT
- **Authorized official:** SANDY L LUCAS (MANAGER)
- **Authorized official phone:** (228) 475-3411

## Contact information

- **Practice address:** 12500 HIGHWAY 57, VANCLEAVE, MS 39565-9614
- **Practice address phone:** (228) 826-2156
- **Practice address fax:** (228) 826-2156
- **Mailing address:** PO BOX 8647, MOSS POINT, MS 39562-0010
- **Mailing address phone:** (228) 475-3411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2024
- **Last updated:** 08/16/2024