Provider Demographics
NPI:1659417269
Name:MILLENNIUM PHARMACY SYSTEMS LLC
Entity Type:Organization
Organization Name:MILLENNIUM PHARMACY SYSTEMS LLC
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 1:7100 COLUMBIA GATEWAY DR
Mailing Address - Street 2:STE 100/110
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2140
Mailing Address - Country:US
Mailing Address - Phone:443-285-0306
Mailing Address - Fax:443-285-0308
Practice Address - Street 1:7100 COLUMBIA GATEWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2955
Practice Address - Country:US
Practice Address - Phone:443-285-0306
Practice Address - Fax:443-285-0308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMACY CORPORATION OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-30
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDPW02993336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD412181300Medicaid
MD485655OtherCONTROLLED SUBSTANCE
MDPW0478OtherBOARD OF PHARMACY
MDPW0478OtherBOARD OF PHARMACY