NPIMap

Organization Active NPI

Pharmacy Corporation of America

  • Long Term Care Pharmacy
  • Vancouver, WA
National Provider Identifier
1639735228
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PHARMACY CORPORATION OF AMERICA
Practice address
18110 SE 34TH St Ste 270
Vancouver, WA 98683-9440
Phone
(503) 626-9436
Fax
(844) 308-3027
NPI assigned
May 20, 2019
Organization subpart
Yes
Parent organization
PHARMERICA HOLDINGS, INC.As 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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X
Home Infusion Therapy Pharmacy 3336H0001X
Long Term Care Pharmacy 3336L0003X Primary
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

18110 SE 34TH St Ste 270
Vancouver, WA 98683-9440

Mailing address

3802 Corporex Park Dr Ste 150
Tampa, FL 33619-1135
Phone (813) 318-6039

Other identifiers 8

IdentifierTypeStateIssuer
1702169MedicaidAK
2142140MedicaidWA
500772702MedicaidOR
156273800MedicaidWY
1700643MedicaidAK
0666179MedicaidMT
1639735228MedicaidID
1702409MedicaidAK

Other names 1

  • PharMerica Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20191213001120 WA Part B Supplier - Pharmacy 1850381807 Practice locations: Vancouver, WA
O20200327002936 WA DME Supplier - Pharmacy 1850381807 Practice locations: Vancouver, WA
O20210216002654 WA Part B Supplier - Mass Immunization (Roster Biller Only) 1850381807 2 other NPIs on this enrollment
Practice locations: Vancouver, WA; Spokane Valley, WA; Kent, WA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Beverly Enterrises58 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.

Member of 4

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

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
The Heritage at Lowman Rehabilitation and HealthcareWhite Rock, SC, CCN 425100 Skilled nursing facility Adp of the SNF Oct 31, 2013
Maplewood CenterWest Allis, WI, CCN 525069 Skilled nursing facility Adp of the SNF Jan 31, 2019
Rice Estate Rehabilitation and HealthcareColumbia, SC, CCN 425387 Skilled nursing facility Adp of the SNF Oct 31, 2013
Sharon Care CenterCentralia, WA, CCN 505429 Skilled nursing facility Adp of the SNF Jan 1, 2023
Camden National BankBerlin, NH, CCN 305102 Skilled nursing facility Adp of the SNF Jan 1, 2022
PharmericaPhiladelphia, PA, CCN 396141 Skilled nursing facility Adp of the SNF Jan 25, 2017
Ashford HallIrving, TX, CCN 455748 Skilled nursing facility Adp of the SNF Sep 29, 2015
Kau HospitalKapolei, HI, CCN 125070 Skilled nursing facility Operational/Managerial Control Feb 4, 2025

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1639735228",
    "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": "813-318-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18110 SE 34TH ST STE 270",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839440",
            "telephone_number": "503-626-9436",
            "fax_number": "844-308-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY CORPORATION OF AMERICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA HOLDINGS, INC.",
        "enumeration_date": "2019-05-20",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702169",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2142140",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500772702",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156273800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700643",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0666179",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639735228",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702409",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.