Provider Demographics
NPI:1356174965
Name:MILLENNIUM PHARMACY SYSTEMS LLC
Entity type:Organization
Organization Name:MILLENNIUM PHARMACY SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-630-7429
Mailing Address - Street 1:PO BOX 85096
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60689-5096
Mailing Address - Country:US
Mailing Address - Phone:847-583-5610
Mailing Address - Fax:
Practice Address - Street 1:7100 COLUMBIA GATEWAY DR STE 100110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2140
Practice Address - Country:US
Practice Address - Phone:877-791-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA HOLDINGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPW0512OtherSTATE BOARD OF PHARMACY