Healthcare Provider Details
I. General information
NPI: 1841223419
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 FAIRFIELD BLVD STE 103
WALLINGFORD CT
06492-1890
US
IV. Provider business mailing address
3802 CORPOREX PARK DR STE 150
TAMPA FL
33619-1135
US
V. Phone/Fax
- Phone: 860-829-6575
- Fax: 860-829-4110
- Phone: 813-318-6039
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | PCY1654 |
| License Number State | CT |
VIII. Authorized Official
Name:
ALLISON
L.
BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429