Provider Demographics
NPI:1992030076
Name:PEARSON, PERRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:PEARSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8214 N 21ST DR UNIT 106A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4942
Mailing Address - Country:US
Mailing Address - Phone:602-864-8815
Mailing Address - Fax:
Practice Address - Street 1:8214 N 21ST DR UNIT 106A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4942
Practice Address - Country:US
Practice Address - Phone:602-864-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist