Organization Active NPI

Pharmacy Corporation of America

Long Term Care Pharmacy
Indianapolis, IN

National Provider Identifier

1730112301

Registry record updated Feb 13, 2024

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Ownership & related parties
NPI Registry JSON
Other providers in Indianapolis, IN
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Long Term Care PharmacyTaxonomy code 3336L0003X
License: 60005275A Issued in IN
Legal business name: PHARMACY CORPORATION OF AMERICA
Doing business as: PHARMERICA
Practice address: 6330 E 75TH St
Suite 322
Indianapolis, IN 46250-2777
Phone: (317) 595-6270
Fax: (317) 595-6283
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 4

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Parenteral & Enteral Nutrition Supplies (DME)	332BP3500X
Home Infusion Therapy Pharmacy	3336H0001X
Long Term Care Pharmacy	3336L0003X	60005275A	IN	Primary

Addresses

Primary practice location

6330 E 75TH St
Suite 322
Indianapolis, IN 46250-2777

Mailing address

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

Other identifiers 21

Identifier	Type	State	Issuer
1671353	Medicaid	AK
1730112301	Medicaid	CT
1730112301	Medicaid	ID
10025898302	Medicaid	NE
100292390A	Medicaid	IN
1529607	Other		OTHER ID NUMBER-COMMERCIAL NUMBER
1730112301	Medicaid	NV
600045200	Medicaid	MO
1730112301	Medicaid	CO
1730112301	Medicaid	CA
262456	Medicaid	AZ
10555500	Medicaid	FL
7100484140	Medicaid	KY
0608530	Medicaid	NJ
9538500000000	Medicaid	IL
1730112301	Medicaid	NC
1730112301	Medicaid	IA
546608301	Medicaid	MD
UNK	Medicaid	AR
1730112301	Medicaid	MI
2139215	Medicaid	OH

Other names 1

PHARMERICA Doing business as

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in IN2 enrollments

Enrollment records 2

Enrollment ID	State	Provider type	PAC ID	Details
O20100930035597	IN	DME Supplier - Pharmacy	1850381807	Practice locations: Indianapolis, IN
O20210310001874	IN	Part B Supplier - Mass Immunization (Roster Biller Only)	1850381807	1 other NPI on this enrollment Practice locations: Indianapolis, IN

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 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Pharmacy Corporation of America
- Specialty Pharmacy
- Indianapolis, IN
- NPI 1972057248
NPD tax ID

Member of 4

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

Continuumcare Pharmacy LLC
- Long Term Care Pharmacy
- Huntington, WV
- NPI 1245275551
Member Of
NPD member
Insta-Care Pharmacy Services Corporation
- Long Term Care Pharmacy
- San Antonio, TX
- NPI 1528091105
Member Of
NPD member
Pharmerica Long-Term Care LLC
- Long Term Care Pharmacy
- El Paso, TX
- NPI 1073546651
Member Of
NPD member
Walgreen Co
- Pharmacy
- Menomonie, WI
- NPI 1962417048
Member Of
NPD member

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.

Facility	Type	Role	Since
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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1730112301",
    "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": "6330 E 75TH ST",
            "address_2": "SUITE 322",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502777",
            "telephone_number": "317-595-6270",
            "fax_number": "317-595-6283"
        }
    ],
    "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": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "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": "IN",
            "license": "60005275A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1671353",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025898302",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100292390A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1529607",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600045200",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262456",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10555500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100484140",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608530",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9538500000000",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546608301",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNK",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730112301",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2139215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

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.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.