Provider Demographics
NPI:1982637567
Name:PHARMERICA DRUG SYSTEMS INC
Entity Type:Organization
Organization Name:PHARMERICA DRUG SYSTEMS INC
Other - Org Name:PHARMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEBBLES
Authorized Official - Middle Name:
Authorized Official - Last Name:PANGRAZIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-975-2273
Mailing Address - Street 1:PO BOX 409244
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-9244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:198 US HIGHWAY 23 N
Practice Address - Street 2:SUITE B
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290-6112
Practice Address - Country:US
Practice Address - Phone:276-386-3700
Practice Address - Fax:276-386-6466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4833845OtherOTHER ID NUMBER-COMMERCIAL NUMBER