Provider Demographics
NPI:1295525996
Name:BRANSON DRUG LLC
Entity type:Organization
Organization Name:BRANSON DRUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:417-527-0585
Mailing Address - Street 1:168 S PAYNE STEWART DR STE 150
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2709
Mailing Address - Country:US
Mailing Address - Phone:417-527-0585
Mailing Address - Fax:
Practice Address - Street 1:168 S PAYNE STEWART DR STE 150
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2709
Practice Address - Country:US
Practice Address - Phone:417-527-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy