1538128947 NPI number — MCKESSON SPECIALTY PHARMACEUTICALS LLC

Table of content: (NPI 1538128947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538128947 NPI number — MCKESSON SPECIALTY PHARMACEUTICALS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCKESSON SPECIALTY PHARMACEUTICALS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538128947
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5712 JARVIS STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70123-2222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-736-7827
Provider Business Mailing Address Fax Number:
504-736-0926

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5712 JARVIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70123-2222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-736-7827
Provider Business Practice Location Address Fax Number:
504-736-0926
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NIXON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
504-613-2909

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  4767-IR , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0553354 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6087520401 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000006597 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1928108 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0022292 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28202058 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 330693 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54003421 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1269336 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 685084 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: PH712LA , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com