Provider Demographics
NPI:1457784928
Name:PILCHER, LARRY SR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:PILCHER
Suffix:SR
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 1:2896 MCDOWELL ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-4238
Mailing Address - Country:US
Mailing Address - Phone:601-371-7350
Mailing Address - Fax:601-371-7747
Practice Address - Street 1:2896 MCDOWELL ROAD EXT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-4238
Practice Address - Country:US
Practice Address - Phone:601-371-7350
Practice Address - Fax:601-371-7747
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist