Healthcare Provider Details

I. General information

NPI: 1679409098
Provider Name (Legal Business Name): MAX EDWARD PIERSON PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SMITH AVE N
SAINT PAUL MN
55102-2344
US

IV. Provider business mailing address

333 SMITH AVE N
SAINT PAUL MN
55102-2344
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-8851
  • Fax: 651-241-2031
Mailing address:
  • Phone: 651-241-8851
  • Fax: 651-241-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number123647
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: