Organization Active NPI

Pharmacy Corporation of America

Doing business as Pharmerica

  • Long Term Care Pharmacy
  • Wallingford, CT
National Provider Identifier
1841223419
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PCY1654 Issued in CT
Legal business name
PHARMACY CORPORATION OF AMERICA
Doing business as
Pharmerica
Practice address
8 Fairfield Blvd Ste 103
Wallingford, CT 06492-1890
Phone
(860) 829-6575
Fax
(860) 829-4110
NPI assigned
Jul 8, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X PCY1654 CT Primary

Addresses

Primary practice location

8 Fairfield Blvd Ste 103
Wallingford, CT 06492-1890

Mailing address

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

Other identifiers 9

IdentifierTypeStateIssuer
01552643MedicaidNY
0716211OtherOTHER ID NUMBER-COMMERCIAL NUMBER
6160030MedicaidRI
1016250MedicaidVT
110021711JMedicaidMA
1015089MedicaidVT
004126274MedicaidCT
004128600MedicaidCT
1841223419MedicaidCT

Other names 1

  • PHARMERICA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930043170 CT DME Supplier - Pharmacy 1850381807 Practice locations: Wallingford, CT
O20210325002207 CT Part B Supplier - Mass Immunization (Roster Biller Only) 1850381807 Practice locations: Wallingford, CT

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 1

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

Member of 4

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

Locations

8 Fairfield Blvd
Ste 103
Wallingford, CT 06492
Phone (800) 282-4321

3802 Corporex Park Dr
Ste 150
Tampa, FL 33619
Phone (813) 378-6274

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.

FacilityTypeRoleSince
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": "1841223419",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FAIRFIELD BLVD STE 103",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921890",
            "telephone_number": "860-829-6575",
            "fax_number": "860-829-4110"
        }
    ],
    "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "PCY1654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01552643",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0716211",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6160030",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016250",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110021711J",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015089",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004126274",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004128600",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841223419",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.