Active NPI
Pharmacy Corporation of America
- Durable Medical Equipment & Medical Supplies
- Smyrna, GA
National Provider Identifier
1801802210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- PHARMACY CORPORATION OF AMERICA
- Practice address
- 1100 Wilson Way
Ste 500
Smyrna, GA 30082 - Phone
- (770) 432-1621
- Fax
- (800) 722-3599
- NPI assigned
- Jul 31, 2006
- Organization subpart
- Yes
- Parent organization
- PHARMERICA CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas A. Caneris
- Title
- Vice President
- Phone
- (502) 627-7100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X |
Addresses
Primary practice location
1100 Wilson Way
Ste 500
Smyrna, GA 30082
Mailing address
3802 Corporex Park Dr
Ste 200
Tampa, FL 33619-1125
Phone (813) 318-6039
Other identifiers 27
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558559 | Medicaid | LA | |
| 200264800A | Medicaid | IN | |
| 000255516B | Medicaid | GA | |
| 100080240D | Medicaid | KS | |
| 9151500 | Medicaid | SD | |
| 009610640 | Medicaid | AL | |
| 106298101 | Medicaid | FL | |
| 55365 | Medicaid | ND | |
| 622449114 | Medicaid | MO | |
| 009149368 | Medicaid | VA | |
| 33037000 | Medicaid | WI | |
| 7701221 | Medicaid | NC | |
| 0392427 | Medicaid | OH | |
| 150921801 | Medicaid | TX | |
| 1801802210 | Medicaid | CT | |
| 3541753 | Medicaid | TN | |
| 9000795600 | Medicaid | KY | |
| PC72436 | Medicaid | RI | |
| 033685800 | Medicaid | DC | |
| 30009810 | Medicaid | NH | |
| 377417000 | Medicaid | MN | |
| 661057900 | Medicaid | MN | |
| 8082344 | Medicaid | ID | |
| 00040355 | Medicaid | MS | |
| 1007739010019 | Medicaid | PA | |
| 200035360C | Medicaid | OK | |
| 4914077 | Medicaid | MI |
Other names 1
- Phar Merica
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930063280 | GA | DME Supplier - Pharmacy | 1850381807 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Smyrna, GA |
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 DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1358985600000",
"number": "1801802210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3802 CORPOREX PARK DR",
"address_2": "STE 200",
"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": "1100 WILSON WAY",
"address_2": "STE 500",
"city": "SMYRNA",
"state": "GA",
"postal_code": "30082",
"telephone_number": "770-432-1621",
"fax_number": "800-722-3599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARMACY CORPORATION OF AMERICA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PHARMERICA CORPORATION",
"enumeration_date": "2006-07-31",
"last_updated": "2013-01-24",
"status": "A",
"authorized_official_last_name": "CANERIS",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "502-627-7100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
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{
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{
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{
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{
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"identifier": "33037000",
"state": "WI"
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{
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{
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"state": "CT"
},
{
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"identifier": "3541753",
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},
{
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"identifier": "9000795600",
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{
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"identifier": "PC72436",
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{
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"issuer": null,
"identifier": "033685800",
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{
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{
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"identifier": "377417000",
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{
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{
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"issuer": null,
"identifier": "8082344",
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{
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"issuer": null,
"identifier": "00040355",
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},
{
"code": "05",
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"issuer": null,
"identifier": "1007739010019",
"state": "PA"
},
{
"code": "05",
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"issuer": null,
"identifier": "200035360C",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4914077",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Phar Merica",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.