NPIMap

Organization Active NPI

Pharmacy Corporation of America

  • Long Term Care Pharmacy
  • Daphne, AL
National Provider Identifier
1497788061
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
111206 Issued in AL
Legal business name
PHARMACY CORPORATION OF AMERICA
Practice address
9052 Independence Ave
Daphne, AL 36526-5613
Phone
(251) 625-6270
Fax
(251) 626-5342
NPI assigned
Jul 8, 2006
Organization subpart
Yes
Parent organization
PHARMERICA CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 111206 AL Primary

Addresses

Primary practice location

9052 Independence Ave
Daphne, AL 36526-5613

Mailing address

3802 Corporex Park Dr
Ste 150
Tampa, FL 33619-1125
Phone (813) 318-6039

Other identifiers 2

IdentifierTypeStateIssuer
0121955OtherOTHER ID NUMBER-COMMERCIAL NUMBER
100003259MedicaidAL

Other names 1

  • PHARMERICA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210219000920 AL Part B Supplier - Mass Immunization (Roster Biller Only) 1850381807 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hoover, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 4

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

Locations

9052 Independence Ave
Daphne, AL 36526
Phone (251) 625-6270

Practitioners & affiliated clinicians

Practitioners 3

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": "1707868800000",
    "number": "1497788061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 CORPOREX PARK DR",
            "address_2": "STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191125",
            "telephone_number": "813-318-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9052 INDEPENDENCE AVE",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365265613",
            "telephone_number": "251-625-6270",
            "fax_number": "251-626-5342"
        }
    ],
    "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": "2024-02-14",
        "certification_date": "2024-02-14",
        "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AL",
            "license": "111206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0121955",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003259",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.