Provider Demographics
NPI:1295627644
Name:BURNSVILLE HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:BURNSVILLE HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:662-279-9710
Mailing Address - Street 1:600 HIGHWAY 365
Mailing Address - Street 2:
Mailing Address - City:TISHOMINGO
Mailing Address - State:MS
Mailing Address - Zip Code:38873-9392
Mailing Address - Country:US
Mailing Address - Phone:662-279-9710
Mailing Address - Fax:
Practice Address - Street 1:301 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MS
Practice Address - Zip Code:38833-9103
Practice Address - Country:US
Practice Address - Phone:662-279-9710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy