Provider Demographics
NPI:1790095412
Name:PCC ACQUISITION COMPANY , LLC
Entity Type:Organization
Organization Name:PCC ACQUISITION COMPANY , LLC
Other - Org Name:OMNICARE OF AURORA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUKULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-719-2600
Mailing Address - Street 1:201 E 4TH ST
Mailing Address - Street 2:900 OMNICARE CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-4248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:480 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-2092
Practice Address - Country:US
Practice Address - Phone:800-788-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336I0012XSuppliersPharmacyInstitutional Pharmacy