NPIMap

Organization Active NPI

Pharmacy Corporation of America

Doing business as Propac Payless Pharmacy

  • Long Term Care Pharmacy
  • Everett, WA
National Provider Identifier
1093799843
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHAR.CF60408436 Issued in WA
Legal business name
PHARMACY CORPORATION OF AMERICA
Doing business as
Propac Payless Pharmacy
PropacPayless Pharmacy
Practice address
111 SE Everett Mall Way
Ste A100
Everett, WA 98208-3208
Phone
(503) 626-9436
Fax
(800) 982-2730
NPI assigned
Dec 5, 2005
Last updated
May 24, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PHARMERICA HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Authorized official

Name
Stephen A Lariviere
Title
Chief Compliance Officer
Phone
(502) 627-7404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X PHAR.CF60408436 WA Primary

Addresses

Primary practice location

111 SE Everett Mall Way
Ste A100
Everett, WA 98208-3208

Mailing address

PO Box 409244
Atlanta, GA 30384-9244
Phone (813) 378-6274

Other identifiers 2

IdentifierTypeStateIssuer
2108264OtherPK
6024269MedicaidWA

Other names 2

  • Propac Payless Pharmacy Doing business as
  • PropacPayless Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rush Pharmacy58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 5

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

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": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1093799843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409244",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303849244",
            "telephone_number": "813-378-6274",
            "fax_number": "813-318-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SE EVERETT MALL WAY",
            "address_2": "STE A100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083208",
            "telephone_number": "503-626-9436",
            "fax_number": "800-982-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY CORPORATION OF AMERICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA HOLDINGS, INC.",
        "enumeration_date": "2005-12-05",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "LARIVIERE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "502-627-7404"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WA",
            "license": "PHAR.CF60408436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108264",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024269",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Propac Payless Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Propac Payless Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PropacPayless Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.