Provider Demographics
NPI:1487687059
Name:PHARMERICA DRUG SYSTEMS LLC
Entity Type:Organization
Organization Name:PHARMERICA DRUG SYSTEMS LLC
Other - Org Name:PHARMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2100
Mailing Address - Street 1:805 N WHITTINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7101
Mailing Address - Country:US
Mailing Address - Phone:502-394-2100
Mailing Address - Fax:
Practice Address - Street 1:775 BELL RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9509
Practice Address - Country:US
Practice Address - Phone:941-342-2500
Practice Address - Fax:941-377-3294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-08
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 3336L0003X
FLPH15702333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106300600Medicaid
VA0214001330OtherSTATE BOARD OF PHARMACY
PA1007511810039Medicaid
1064714OtherOTHER ID NUMBER-COMMERCIAL NUMBER
FLPH15702OtherSTATE BOARD OF PHARMACY
1064714OtherOTHER ID NUMBER-COMMERCIAL NUMBER
MI1487687059Medicaid
NV1487687059Medicaid
VA1487687059Medicaid
SC7F5702Medicaid
PA1007511810039Medicaid
CO94884072Medicaid
MD016626000Medicaid
NV1487687059Medicaid