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Contact Information

JOE R BOURN SR, RPH
31 FRONT ST
COFFEEVILLE, MS38922
 Phone: 662-675-2775
 Fax: 662-675-8477
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for JOE R BOURN SR · (Male)

NPI # 1033258264
Status Active
Credentials RPH (Registered Pharmacist)
Entity Individual
Enumeration date 02/05/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MS License # E5330
  • MS Medicaid 0093220
  • Other 2502880 NABP # FED
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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