Organization Active NPI

Pharmacy Corporation of America

  • Long Term Care Pharmacy
  • Westlake, OH
National Provider Identifier
1275566853
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
02-0718000 Issued in OH
Legal business name
PHARMACY CORPORATION OF AMERICA
Practice address
24165 Detroit Rd
Westlake, OH 44145-1516
Phone
(866) 883-7646
Fax
(440) 617-1815
NPI assigned
Jul 8, 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
Allison L. Brown
Title
Secretary
Phone
(502) 630-7429

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X 02-0718000 OH Primary

Addresses

Primary practice location

24165 Detroit Rd
Westlake, OH 44145-1516

Mailing address

PO Box 409244
Atlanta, GA 30384-9244

Other identifiers 9

IdentifierTypeStateIssuer
0895536MedicaidOH
1007739010007MedicaidPA
02660075MedicaidNY
6001380000MedicaidWV
010182051MedicaidVA
200506760AMedicaidIN
3657484OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3657484MedicaidMI
1011558MedicaidVT

Other names 1

  • PHARMERICA Doing business as

National Provider Directory

National Provider Directory

Member of 4

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

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": "1275566853",
    "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": "24165 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451516",
            "telephone_number": "866-883-7646",
            "fax_number": "440-617-1815"
        }
    ],
    "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OH",
            "license": "02-0718000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895536",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007739010007",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02660075",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001380000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010182051",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200506760A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3657484",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3657484",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011558",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.