Pharmacy Corporation of America

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

02191/02.3 Issued in MS

Legal business name

PHARMACY CORPORATION OF AMERICA

Practice address

950 W County Line Rd Ste 100
Jackson, MS 39213-9302

Phone

(800) 445-4168

Fax

(601) 206-1105

NPI assigned

Jul 8, 2006

Organization subpart

Yes

Parent organization

PHARMERICA CORPORATIONAs reported in NPPES

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

Addresses

Other identifiers 2

Other names 1

• PHARMERICA Doing business as

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

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

Tax ID family

Beverly Enterrises58 organizations share this tax ID, including this one

Member of 4

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

• Continuumcare Pharmacy LLC

  • Long Term Care Pharmacy
  • Huntington, WV
  • NPI 1245275551

  Member Of

  NPD member
• Insta-Care Pharmacy Services Corporation

  • Long Term Care Pharmacy
  • San Antonio, TX
  • NPI 1528091105

  Member Of

  NPD member
• Pharmerica Long-Term Care LLC

  • Long Term Care Pharmacy
  • El Paso, TX
  • NPI 1073546651

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Menomonie, WI
  • NPI 1962417048

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 8

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

Practitioners 2

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

• Robert Leon Burford III

  • Geriatric Pharmacist
  • Jackson, MS
  • NPI 1194317958
  NPD
• Ronald Edward Waller, RPH

  • Pharmacist
  • Ridgeland, MS
  • NPI 1336689801
  NPD (past)

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": "1093748675",
    "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": "950 W COUNTY LINE RD STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392139302",
            "telephone_number": "800-445-4168",
            "fax_number": "601-206-1105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Highpoint Dr",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391576019",
            "country_code": "US",
            "telephone_number": "601-956-1132",
            "fax_number": "601-206-1105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "MS",
            "license": "02191/02.3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2500937",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030230",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mimi Pham, MD
• Thuy-Vy Lillian Pham
• Ha Phan, PHARMD
• Lana Ngoc Phan, M.D.
• Andrea Phang
• Barbara J Phelps
• Phillip K Blevins, MD, PLLC
• Dino R Phillippi, MD
• Phillips Medical Services PLLC
• Andrea L Phillips, M.C.

• Long Term Care Pharmacy in Jackson, MS
• Providers in Jackson, MS by specialty
• Long Term Care Pharmacy in Mississippi

• 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.