Provider Demographics
NPI:1376636001
Name:BURNS PHARMACY, INC.
Entity Type:Organization
Organization Name:BURNS PHARMACY, INC.
Other - Org Name:BURNS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / R.PH.
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-841-6436
Mailing Address - Street 1:541 JACKSON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TARRANT
Mailing Address - State:AL
Mailing Address - Zip Code:35217
Mailing Address - Country:US
Mailing Address - Phone:205-841-6436
Mailing Address - Fax:205-841-6432
Practice Address - Street 1:541 JACKSON BOULEVARD
Practice Address - Street 2:
Practice Address - City:TARRANT
Practice Address - State:AL
Practice Address - Zip Code:35217
Practice Address - Country:US
Practice Address - Phone:205-841-6436
Practice Address - Fax:205-841-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0102563OtherNABP