Provider Demographics
NPI:1306918222
Name:PEARSON DRUGS NO 7 LLC
Entity type:Organization
Organization Name:PEARSON DRUGS NO 7 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:318-776-5649
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:LECOMPTE
Mailing Address - State:LA
Mailing Address - Zip Code:71346-0369
Mailing Address - Country:US
Mailing Address - Phone:318-776-5649
Mailing Address - Fax:318-776-9212
Practice Address - Street 1:1806 WATER ST
Practice Address - Street 2:
Practice Address - City:LECOMPTE
Practice Address - State:LA
Practice Address - Zip Code:71346-9545
Practice Address - Country:US
Practice Address - Phone:318-776-5649
Practice Address - Fax:318-776-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.3151-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2029930OtherPK
LA1262609Medicaid
LA1262609Medicaid