Pharmerica Midwest LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

1206 Issued in IA

Legal business name

PHARMERICA MIDWEST LLC

Doing business as

PharMerica

Practice address

4105 Westcor Court
Suite 1
Coralville, IA 52241

Phone

(319) 545-7090

Fax

(319) 545-7095

NPI assigned

Aug 9, 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

Mr. Thomas A. Caneris

Title

Vice President

Phone

(502) 627-7100

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• PharMerica Doing business as

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.

• Pharmerica Midwest LLC

  dba PharMerica

  • Long Term Care Pharmacy
  • Urbandale, IA
  • NPI 1336150580
  NPD tax ID

Locations

Practitioners 2

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

• Kirk D Crabtree, PHARM.D

  • Pharmacist
  • Coralville, IA
  • NPI 1316157985
  NPD (past)
• Jennica Yatskis

  • Pharmacist
  • Coralville, IA
  • NPI 1114137783
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1184634347",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 WESTCOR COURT",
            "address_2": "SUITE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-545-7090",
            "fax_number": "319-545-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMERICA MIDWEST LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA CORPORATION",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "CANERIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-627-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498048",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Craig Michael Petitgout, D.C.
• Petitgout, Inc.
• Jason Pfeifer, OD
• Hannah Marie Pfister
• Kathie Pham
• Phleb-Express Inc
• Nadia Phouphommakhith
• Phyllis Chang, M.D., PLC
• Physiotherapy Associates Inc
• Julie Ann Piegors

• Long Term Care Pharmacy in Coralville, IA
• Providers in Coralville, IA by specialty
• Long Term Care Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.