Provider Demographics
NPI:1134339088
Name:PIERCE, JEFFREY A (PHARM D)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:PIERCE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22772 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66052-4153
Mailing Address - Country:US
Mailing Address - Phone:785-542-3066
Mailing Address - Fax:
Practice Address - Street 1:22772 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:KS
Practice Address - Zip Code:66052-4153
Practice Address - Country:US
Practice Address - Phone:785-542-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist