Provider Demographics
NPI:1740512102
Name:BURGE MANAGMENT & MARKETING, LLC
Entity type:Organization
Organization Name:BURGE MANAGMENT & MARKETING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VERON
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-543-6575
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:PURVIS
Mailing Address - State:MS
Mailing Address - Zip Code:39475-0253
Mailing Address - Country:US
Mailing Address - Phone:601-794-2121
Mailing Address - Fax:601-794-2199
Practice Address - Street 1:177 SHELBY SPEIGHTS
Practice Address - Street 2:SUITE C
Practice Address - City:PURVIS
Practice Address - State:MS
Practice Address - Zip Code:39475
Practice Address - Country:US
Practice Address - Phone:601-794-2121
Practice Address - Fax:601-794-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08391/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies