Pharmerica Mountain LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

1929LS Issued in ID

Legal business name

PHARMERICA MOUNTAIN LLC

Doing business as

PharMerica

Practice address

2950 E Magic View Dr Ste 190
Meridian, ID 83642

Phone

(208) 887-1951

Fax

(208) 895-9825

NPI assigned

Aug 13, 2006

Last updated

Feb 13, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

PHARMERICA CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Allison L. Brown

Title

Secretary

Phone

(502) 630-7429

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• PharMerica Doing business as

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

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

• Pharmerica Mountain LLC

  dba PharMerica

  • Long Term Care Pharmacy
  • North Las Vegas, NV
  • NPI 1346261575

  7810107158

  Same PAC ID

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

Tax ID family

Pharmerica2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pharmerica Mountain LLC

  dba PharMerica

  • Long Term Care Pharmacy
  • North Las Vegas, NV
  • NPI 1346261575
  NPD tax ID

Member of 3

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

• Pharmacy Corporation of America

  dba PharMerica

  • Long Term Care Pharmacy
  • West Henrietta, NY
  • NPI 1407395270

  Member Of

  NPD member
• Pharmerica Institutional Pharmacy Services LLC

  dba PharMerica

  • Long Term Care Pharmacy
  • Concord, NH
  • NPI 1215047238

  Member Of

  NPD member
• Walgreen Co

  dba Walgreens #07319

  • Pharmacy
  • Adrian, MI
  • NPI 1487669529

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pharmerica Institutional Pharmacy Services LLC

  dba PharMerica

  • Long Term Care Pharmacy
  • Concord, NH
  • NPI 1215047238

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Silvius

  • Geriatric Pharmacist
  • Meridian, ID
  • NPI 1255618641
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1760494033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N WHITTINGTON PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402227101",
            "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": "2950 E MAGIC VIEW DR STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-887-1951",
            "fax_number": "208-895-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMERICA MOUNTAIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA CORPORATION",
        "enumeration_date": "2006-08-13",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "ID",
            "license": "1929LS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "47154LS",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6022362",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704147",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807106500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "RP-0002900",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276268",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PharMerica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Meridian, ID
• Providers in Meridian, ID by specialty
• Long Term Care Pharmacy in Idaho

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.