Healthcare Provider Details

I. General information

NPI: 1932110509
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 US HIGHWAY 90 STE 300
DAPHNE AL
36526-9512
US

IV. Provider business mailing address

3802 CORPOREX PARK DR STE 200
TAMPA FL
33619-1125
US

V. Phone/Fax

Practice location:
  • Phone: 877-770-7923
  • Fax: 866-478-7909
Mailing address:
  • Phone: 813-318-6039
  • Fax: 800-825-6408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number112833
License Number StateAL

VIII. Authorized Official

Name: THOMAS A CANERIS
Title or Position: VICE PREISDENT
Credential:
Phone: 502-627-7100