Provider Demographics
NPI:1508611005
Name:PIERSON PHARMACY GROUP, LLC
Entity Type:Organization
Organization Name:PIERSON PHARMACY GROUP, LLC
Other - Org Name:KRATZER'S HOMETOWN PHARMACY MOUNT ORAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:937-205-8778
Mailing Address - Street 1:7929 SWARTZ RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45142-8154
Mailing Address - Country:US
Mailing Address - Phone:937-205-8778
Mailing Address - Fax:
Practice Address - Street 1:155 N POINT DR
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8366
Practice Address - Country:US
Practice Address - Phone:937-205-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy