Provider Demographics
NPI:1083849640
Name:PCA-CORRECTIONS LLC
Entity Type:Organization
Organization Name:PCA-CORRECTIONS LLC
Other - Org Name:CURO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-266-2558
Mailing Address - Street 1:4665 44TH ST SE STE A1106
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-4052
Mailing Address - Country:US
Mailing Address - Phone:616-977-9700
Mailing Address - Fax:616-855-0937
Practice Address - Street 1:4665 44TH ST SE STE A1106
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-4052
Practice Address - Country:US
Practice Address - Phone:616-977-9700
Practice Address - Fax:616-855-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010099513336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137979OtherPK