Provider Demographics
NPI:1710910393
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: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 1:3802 CORPOREX PARK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1135
Mailing Address - Country:US
Mailing Address - Phone:502-627-7000
Mailing Address - Fax:502-627-7401
Practice Address - Street 1:217 WITMER RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2212
Practice Address - Country:US
Practice Address - Phone:610-337-6820
Practice Address - Fax:800-275-3149
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-08
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PAPP413876L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02143988Medicaid
3953141OtherOTHER ID NUMBER-COMMERCIAL NUMBER
WA6032122Medicaid
PA1007511810027Medicaid
CT94003109172Medicaid
DC019308200Medicaid
WV6003125000Medicaid
NJ8428000Medicaid
VA8519889Medicaid
DE0000879907Medicaid
MD122805600Medicaid
MD122805600Medicaid
NJ8428000Medicaid
DC019308200Medicaid
PA1007511810027Medicaid