NPIMap

Organization Active NPI

Pharmacy Corporation of America

Doing business as Premier Long Term Care Pharmacy

  • Long Term Care Pharmacy
  • Seattle, WA
National Provider Identifier
1821217910
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PHARMACY CORPORATION OF AMERICA
Doing business as
Premier Long Term Care Pharmacy
Practice address
1618 S Lane St Ste 204
Seattle, WA 98144
Phone
(206) 323-0868
Fax
(206) 323-9206
NPI assigned
Apr 25, 2007
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PHARMERICA CORPORATEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Thomas Caneris
Title
Vice President
Phone
(502) 627-7100

Specialties & licenses 2

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

Addresses

Primary practice location

1618 S Lane St Ste 204
Seattle, WA 98144

Mailing address

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

Other practice location 1

5405 Rainier Ave S
Seattle, WA 98118-2438
Phone (206) 722-8882

Other identifiers 2

IdentifierTypeStateIssuer
4932326OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6029987MedicaidWA

Other names 1

  • Premier Long Term Care Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pharmacy Corp of Americ59 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.

Locations

1618 S Lane St
Ste 204
Seattle, WA 98144
Phone (206) 323-0868

5405 Rainier Ave S
Seattle, WA 98118
Phone (206) 722-8882

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1821217910",
    "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",
            "fax_number": "800-825-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S LANE ST STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98144",
            "telephone_number": "206-323-0868",
            "fax_number": "206-323-9206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5405 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981182438",
            "country_code": "US",
            "telephone_number": "206-722-8882",
            "fax_number": "206-722-8886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHARMACY CORPORATION OF AMERICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMERICA CORPORATE",
        "enumeration_date": "2007-04-25",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "CANERIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-627-7100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4932326",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6029987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Long Term Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.