Provider Demographics
NPI:1104842053
Name:PHARMACY CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:PHARMACY CORPORATION OF AMERICA
Other - Org Name:PHARMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-630-7429
Mailing Address - Street 1:3 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2801
Mailing Address - Country:US
Mailing Address - Phone:410-228-1012
Mailing Address - Fax:410-228-1024
Practice Address - Street 1:3 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2801
Practice Address - Country:US
Practice Address - Phone:410-228-1012
Practice Address - Fax:410-228-1024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMACY CORPORATION OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDPW03343336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD499946OtherCONTROLLED SUBSTANCE
MDPW0526OtherMD BOARD OF PHARMACY
MD961303000Medicaid
2122808OtherNCPDP PROVIDER IDENTIFICATION NUMBER