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General NPI Number Information
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NPI Number | 1043524317
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Entity Type | Organization
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Legal Business Name | PHARMACEUTICAL SPECIALTIES LLC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 502 W KING ST # LL20
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3362
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Country | US
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Telephone | 800-818-6486
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Fax | 980-613-4324
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Provider Business Mailing Address
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Address Line | PO BOX 1353
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City | AMARILLO
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State | TX
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Zip | 79105-1353
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Country | US
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Telephone | 806-242-7782
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Fax | 980-613-4324
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Authorized Official
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Title or Position | SR. DIR. PHARMACY PAYOR CONTRACTING
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Name | RYAN ATKINSON
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Credential |
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Telephone | 806-242-7782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 13118
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License Number State | NC
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