Provider Demographics
NPI:1821843228
Name:PIERSON PHARMACY GROUP, LLC
Entity Type:Organization
Organization Name:PIERSON PHARMACY GROUP, LLC
Other - Org Name:PIERSON PHARMACY (LONG-TERM CARE)
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 1:211 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:OH
Practice Address - Zip Code:45142-1008
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
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy