NPIMap

Organization Active NPI

Pharmerica Drug Systems LLC

  • Long Term Care Pharmacy
  • Grand Rapids, MI
National Provider Identifier
1376576959
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5301007793 Issued in MI
Legal business name
PHARMERICA DRUG SYSTEMS LLC
Practice address
4575 44TH St SE
Suite a
Grand Rapids, MI 49512-4080
Phone
(616) 954-6833
Fax
(616) 954-3806
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X 5301007793 MI Primary

Addresses

Primary practice location

4575 44TH St SE
Suite a
Grand Rapids, MI 49512-4080

Mailing address

3802 Corporex Park Dr Ste 150
Tampa, FL 33619-1135
Phone (502) 627-7000

Other identifiers 3

IdentifierTypeStateIssuer
2365345OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2365345MedicaidMI
4883936MedicaidMI

Other names 1

  • PHARMERICA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930009203 MI DME Supplier - Pharmacy 9537280086 Practice locations: Grand Rapids, MI
O20210318000178 MI Part B Supplier - Mass Immunization (Roster Biller Only) 9537280086 1 other NPI on this enrollment
Practice locations: Grand Rapids, MI

Other NPIs with the same Medicare PAC ID 15

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

View all 15

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 Drug Systems LLC4575 44TH St SE, Grand Rapids, MI 49512-4080(616) 954-6833 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Jan 22, 1999

National Provider Directory

National Provider Directory
Tax ID family
Pharmerica Drug Systems Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Member of 4

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

Ownership & related parties

All facility ownership & control disclosures 33

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

FacilityTypeRoleSince
Valle Verde Health FacilitySanta Barbara, CA, CCN 055733 Skilled nursing facility Adp of the SNF Nov 2, 2017
Monument Health Care CenterSturgis, SD, CCN 435102 Skilled nursing facility Adp of the SNF Aug 1, 2022
Piedmont Gardens Health FacilityOakland, CA, CCN 056096 Skilled nursing facility Adp of the SNF Mar 3, 2017
Rosewood Health FacilityBakersfield, CA, CCN 555116 Skilled nursing facility Adp of the SNF Apr 29, 2025
Summitview Rehab and Health CenterYakima, WA, CCN 505409 Skilled nursing facility Adp of the SNF Feb 22, 2022
PharmericaBryn Mawr, PA, CCN 395753 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Apr 9, 2025
Elmhurst Extended Care CenterElmhurst, IL, CCN 145111 Skilled nursing facility Adp of the SNF Aug 25, 2025
Accel at Willow BendPlano, TX, CCN 676349 Skilled nursing facility Adp of the SNF Aug 27, 2017
Williamsburg Village Healthcare CampusDesoto, TX, CCN 675756 Skilled nursing facility Adp of the SNF Aug 27, 2017
The Plaza at LubbockLubbock, TX, CCN 676105 Skilled nursing facility Adp of the SNF Aug 27, 2017
Garnet Hill Rehabilitation and Skilled CareWylie, TX, CCN 676192 Skilled nursing facility Adp of the SNF Aug 27, 2017
Settlers Ridge Care CenterCelina, TX, CCN 675969 Skilled nursing facility Adp of the SNF Aug 27, 2017
The Villages on MacarthurIrving, TX, CCN 676358 Skilled nursing facility Adp of the SNF Aug 27, 2017
Baybrooke Village Care and Rehab CenterMcKinney, TX, CCN 676096 Skilled nursing facility Adp of the SNF Aug 27, 2017
Elmhurst Rehabilitation and Healthcare CenterProvidence, RI, CCN 415084 Skilled nursing facility Adp of the SNF May 19, 2025
Reunion Plaza Senior Care and Rehabilitation CenterTexarkana, TX, CCN 675444 Skilled nursing facility Adp of the SNF Aug 27, 2017
Heritage Plaza Nursing CenterTexarkana, TX, CCN 675561 Skilled nursing facility Adp of the SNF Aug 27, 2017
Pine Grove Nursing CenterCenter, TX, CCN 675230 Skilled nursing facility Adp of the SNF Aug 27, 2017
Briarcliff Skilled Nursing FacilityCarthage, TX, CCN 676051 Skilled nursing facility Adp of the SNF Aug 27, 2017
Colonial Pines Healthcare CenterSan Augustine, TX, CCN 675358 Skilled nursing facility Adp of the SNF Aug 27, 2017
Redwood Terrace Health CenterEscondido, CA, CCN 555146 Skilled nursing facility Adp of the SNF Jun 30, 2020
Providence Park Rehabilitation and Skilled NursingTyler, TX, CCN 676184 Skilled nursing facility Adp of the SNF Aug 27, 2017
Garland Road Nursing & Rehab CenterEnid, OK, CCN 375527 Skilled nursing facility Adp of the SNF Aug 29, 2017
Highland Park Health CareOkmulgee, OK, CCN 375486 Skilled nursing facility Adp of the SNF Aug 29, 2017
Meadowlake EstatesOklahoma City, OK, CCN 375256 Skilled nursing facility Adp of the SNF Aug 29, 2017
Tuscany Village Nursing CenterOklahoma City, OK, CCN 375536 Skilled nursing facility Adp of the SNF Aug 29, 2017
Ranchwood Nursing CenterYukon, OK, CCN 375229 Skilled nursing facility Adp of the SNF Aug 29, 2017
Noble Health Care CenterNoble, OK, CCN 375245 Skilled nursing facility Adp of the SNF Aug 29, 2017
Montevista Rehabilitation and Skilled CareLawton, OK, CCN 375540 Skilled nursing facility Adp of the SNF Aug 29, 2017
Tulsa Nursing CenterTulsa, OK, CCN 375389 Skilled nursing facility Adp of the SNF Aug 29, 2017
Medical Park West Rehabilitation and Skilled CareNorman, OK, CCN 375551 Skilled nursing facility Adp of the SNF Aug 29, 2017
The Villages at Southern HillsTulsa, OK, CCN 375546 Skilled nursing facility Adp of the SNF Aug 29, 2017
The Boulevard Post AcuteFairfax, VA, CCN 495319 Skilled nursing facility Adp of the SNF May 19, 2025

Owned or controlled facilities with NPI records 33

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 33

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1376576959",
    "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": "502-627-7000",
            "fax_number": "502-627-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 44TH ST SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495124080",
            "telephone_number": "616-954-6833",
            "fax_number": "616-954-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMERICA DRUG SYSTEMS LLC",
        "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": "MI",
            "license": "5301007793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2365345",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365345",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4883936",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.