NPIMap

Organization Active NPI

Pharmacy Corporation of America

Doing business as Pharmerica Kauai

  • Long Term Care Pharmacy
  • Lihue, HI
National Provider Identifier
1003849670
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHY651 Issued in HI
Legal business name
PHARMACY CORPORATION OF AMERICA
Doing business as
Pharmerica Kauai
Practice address
2970 Kele St
Suite 113a
Lihue, HI 96766-1803
Phone
(808) 245-8024
Fax
(808) 245-8165
NPI assigned
Jul 8, 2006
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PHARMERICA CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Allison L. Brown
Title
Secretary
Phone
(502) 630-7429

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X PHY651 HI Primary

Addresses

Primary practice location

2970 Kele St
Suite 113a
Lihue, HI 96766-1803

Mailing address

3802 Corporex Park Dr
Ste 200
Tampa, FL 33619-1125
Phone (813) 318-6039

Other identifiers 2

IdentifierTypeStateIssuer
1204510OtherOTHER ID NUMBER-COMMERCIAL NUMBER
55362901MedicaidHI

Other names 1

  • PHARMERICA KAUAI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930036554 HI DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1850381807 Practice locations: Lihue, HI
O20210216002949 HI Part B Supplier - Mass Immunization (Roster Biller Only) 1850381807 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hilo, HI; Honolulu, HI; Kaneohe, HI; Lihue, HI; Wailuku, HI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pharmerica2970 Kele St, Lihue, HI 96766-1822(866) 543-6292 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 18, 2020

National Provider Directory

National Provider Directory
Tax ID family
Pharmacy Corp of Americ58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Heritage at Lowman Rehabilitation and HealthcareWhite Rock, SC, CCN 425100 Skilled nursing facility Adp of the SNF Oct 31, 2013
Maplewood CenterWest Allis, WI, CCN 525069 Skilled nursing facility Adp of the SNF Jan 31, 2019
Rice Estate Rehabilitation and HealthcareColumbia, SC, CCN 425387 Skilled nursing facility Adp of the SNF Oct 31, 2013
Sharon Care CenterCentralia, WA, CCN 505429 Skilled nursing facility Adp of the SNF Jan 1, 2023
Camden National BankBerlin, NH, CCN 305102 Skilled nursing facility Adp of the SNF Jan 1, 2022
PharmericaPhiladelphia, PA, CCN 396141 Skilled nursing facility Adp of the SNF Jan 25, 2017
Ashford HallIrving, TX, CCN 455748 Skilled nursing facility Adp of the SNF Sep 29, 2015
Kau HospitalKapolei, HI, CCN 125070 Skilled nursing facility Operational/Managerial Control Feb 4, 2025

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1003849670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 CORPOREX PARK DR",
            "address_2": "STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191125",
            "telephone_number": "813-318-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 KELE ST",
            "address_2": "SUITE 113A",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661803",
            "telephone_number": "808-245-8024",
            "fax_number": "808-245-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY CORPORATION OF AMERICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA CORPORATION",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "502-630-7429"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "HI",
            "license": "PHY651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1204510",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55362901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA KAUAI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA KAUAI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.