NPIMap

Organization Active NPI

Pharmerica Long-Term Care LLC

Doing business as Pharmerica

  • Long Term Care Pharmacy
  • Great Falls, MT
National Provider Identifier
1811920499
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
1229 Issued in MT
Legal business name
PHARMERICA LONG-TERM CARE LLC
Doing business as
Pharmerica
Practice address
625 Central Ave W
Suite 105
Great Falls, MT 59404-2874
Phone
(800) 757-3713
Fax
(800) 295-1662
NPI assigned
Jul 8, 2006
Reactivated
Jan 23, 2019
Last updated
Feb 13, 2024By the provider in NPPES
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1065 MT
Long Term Care Pharmacy 3336L0003X 1065 MT
Long Term Care Pharmacy 3336L0003X 1229 MT Primary

Addresses

Primary practice location

625 Central Ave W
Suite 105
Great Falls, MT 59404-2874

Mailing address

3802 Corporex Park Dr
Ste 200
Tampa, FL 33619-1125
Phone (813) 318-6039

Other identifiers 2

IdentifierTypeStateIssuer
PHA-PHR-LIC-58716OtherMTBOARD OF PHARMACY
1811920499MedicaidMT

Other names 1

  • PHARMERICA Doing business as

National Provider Directory

National Provider Directory

Member of 4

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

Member organizations 90

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

View all 90

Locations

625 Central Ave W
Ste 105
Great Falls, MT 59404
Phone (406) 452-3713

4171 N Mesa St
Ste A210
El Paso, TX 79902
Phone (800) 782-7641

Practitioners & affiliated clinicians

Practitioners 5

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.

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": "1811920499",
    "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": "625 CENTRAL AVE W",
            "address_2": "SUITE 105",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594042874",
            "telephone_number": "800-757-3713",
            "fax_number": "800-295-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMERICA LONG-TERM CARE LLC",
        "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",
        "deactivation_date": "2018-06-11",
        "reactivation_date": "2019-01-23",
        "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": "MT",
            "license": "1065",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "1065",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "1229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHA-PHR-LIC-58716",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811920499",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Falls, MT

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.