Provider Demographics
NPI:1265249643
Name:HIGHLAND SPECIALTY PHARMACY LLC
Entity type:Organization
Organization Name:HIGHLAND SPECIALTY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-268-6033
Mailing Address - Street 1:10 C AINSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1869
Mailing Address - Country:US
Mailing Address - Phone:601-268-6033
Mailing Address - Fax:
Practice Address - Street 1:10 C AINSWORTH DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1869
Practice Address - Country:US
Practice Address - Phone:601-268-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLAND SPECIALTY PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy