Provider Demographics
NPI:1043822364
Name:SKERSICK, PIERCE WYLAND (PHARMD)
Entity type:Individual
Prefix:
First Name:PIERCE
Middle Name:WYLAND
Last Name:SKERSICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 MID CITIES DR
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4270
Mailing Address - Country:US
Mailing Address - Phone:479-271-7634
Mailing Address - Fax:
Practice Address - Street 1:2805 MID CITIES DR
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4270
Practice Address - Country:US
Practice Address - Phone:479-271-7634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032180183500000X
ARPD15727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist