Healthcare Provider Details

I. General information

NPI: 1285748178
Provider Name (Legal Business Name): MCKESSON SPECIALTY PHARMACEUTICALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WATERFRONT DR
PITTSBURGH PA
15222-4742
US

IV. Provider business mailing address

PO BOX 730584
DALLAS TX
75373-0584
US

V. Phone/Fax

Practice location:
  • Phone: 412-992-5762
  • Fax: 412-992-5475
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPP481572
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD J VIDIC
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 412-992-5660