NPIMap

Organization Active NPI

Pearson Specialty Pharmacy LLC

  • Long Term Care Pharmacy
  • Alexandria, LA
National Provider Identifier
1487737565
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHY005638IR Issued in LA
Legal business name
PEARSON SPECIALTY PHARMACY LLC
Practice address
2804 N Bolton Ave
Alexandria, LA 71303-4509
Phone
(318) 448-7366
Fax
(318) 448-1328
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marty McKay, RPHNPI 1710901814
Title
Co Owner
Phone
(318) 776-5646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PHY005638IR LA Primary

Addresses

Primary practice location

2804 N Bolton Ave
Alexandria, LA 71303-4509

Mailing address

PO Box 7796
Alexandria, LA 71306-0796
Phone (318) 448-7366

Other identifiers 2

IdentifierTypeStateIssuer
1234486MedicaidLA
2035359OtherPK

Other names 1

  • PEARSON SPECIALTY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181012000048 LA Part B Supplier - Pharmacy 9537367875 Practice locations: Alexandria, LA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2804 N Bolton Ave
Alexandria, LA 71303
Phone (318) 448-7366

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1487737565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7796",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713060796",
            "telephone_number": "318-448-7366",
            "fax_number": "318-448-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 N BOLTON AVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034509",
            "telephone_number": "318-448-7366",
            "fax_number": "318-448-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARSON SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "318-776-5646",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "LA",
            "license": "PHY005638IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234486",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARSON SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEARSON SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.