Provider Demographics
NPI:1992960595
Name:MCKESSON SPECIALTY PHARMACEUTICALS LLC
Entity type:Organization
Organization Name:MCKESSON SPECIALTY PHARMACEUTICALS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:VIDIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-992-5660
Mailing Address - Street 1:700 WATERFRONT DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-4742
Mailing Address - Country:US
Mailing Address - Phone:412-992-5726
Mailing Address - Fax:412-992-5475
Practice Address - Street 1:700 WATERFRONT DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-4742
Practice Address - Country:US
Practice Address - Phone:412-992-5726
Practice Address - Fax:412-992-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4815723336M0002X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3986188OtherNCPDP
PA4530310002Medicare NSC