Healthcare Provider Details
I. General information
NPI: 1730992546
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 MINERAL TRCE STE 200
HOOVER AL
35244-4507
US
IV. Provider business mailing address
PO BOX 409244
ATLANTA GA
30384-9244
US
V. Phone/Fax
- Phone: 800-476-7874
- Fax:
- Phone: 813-318-6656
- Fax: 800-825-6406
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ALLISON
BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429