Healthcare Provider Details

I. General information

NPI: 1942233515
Provider Name (Legal Business Name): PHARMERICA DRUG SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E MERCED ST
FOWLER CA
93625-2312
US

IV. Provider business mailing address

PO BOX 409244
ATLANTA GA
30384-9244
US

V. Phone/Fax

Practice location:
  • Phone: 559-834-1606
  • Fax: 559-834-5841
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY460550
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PEBBLES PANGRAZIO
Title or Position: CONTRACT ADMINISTRATOR
Credential:
Phone: 877-975-2273