NPIMap

Organization Active NPI

Pharmerica East LLC

  • Long Term Care Pharmacy
  • Worthington, OH
National Provider Identifier
1013028042
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
02788 Issued in OH
Legal business name
PHARMERICA EAST LLC
Practice address
720 Lakeview Plaza Blvd
Suite H
Worthington, OH 43085
Phone
(614) 430-9720
Fax
(614) 430-9732
NPI assigned
Aug 31, 2006
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
Mr. Allison L. Brown
Title
Secretary
Phone
(502) 630-7429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 02788 OH Primary

Addresses

Primary practice location

720 Lakeview Plaza Blvd
Suite H
Worthington, OH 43085

Mailing address

3802 Corporex Park Dr Ste 150
Tampa, FL 33619-1135
Phone (813) 318-6039

Other identifiers 6

IdentifierTypeStateIssuer
200943370AMedicaidIN
PSNH021508850OtherOHOH BOARD OF PHARMACY
PSNH.021508850OtherOHBOARD OF PHARMACY
101402588-0002MedicaidPA
2531433MedicaidOH
MO0560122OtherWVWV BOARD OF PHARMACY

Other names 1

  • PharMerica Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930079528 OH DME Supplier - Pharmacy 4284844242 Practice locations: Worthington, OH
O20210209001245 OH Part B Supplier - Mass Immunization (Roster Biller Only) 4284844242 Practice locations: Worthington, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Pharmerica East LLC720 Lakeview Plaza Blvd, Worthington, OH 43085-4733(614) 430-9720 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignmentParticipating since Dec 1, 2004

National Provider Directory

National Provider Directory
Tax ID family
Pharmerica2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1013028042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 CORPOREX PARK DR STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191135",
            "telephone_number": "813-318-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 LAKEVIEW PLAZA BLVD",
            "address_2": "SUITE H",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-430-9720",
            "fax_number": "614-430-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMERICA EAST LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA CORPORATION",
        "enumeration_date": "2006-08-31",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OH",
            "license": "02788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200943370A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH BOARD OF PHARMACY",
            "identifier": "PSNH021508850",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PSNH.021508850",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101402588-0002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2531433",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BOARD OF PHARMACY",
            "identifier": "MO0560122",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.