Organization
PEARSON SPECIALTY PHARMACY LLC
Active
Other names
PEARSON SPECIALTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY MCKAY RPH (CO OWNER)
(318) 776-5646
Entity
Organization
Contact information
Practice address
2804 N BOLTON AVE, ALEXANDRIA, LA 71303-4509
(318) 448-7366
(318) 448-1328
Mailing address
PO BOX 7796, ALEXANDRIA, LA 71306-0796
(318) 448-7366
(318) 448-1328
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY005638IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234486
—
LA
01
—
2035359
PK
—
Enumeration date
10/23/2006
Last updated
10/11/2018
Update your record
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