Healthcare Provider Details

I. General information

NPI: 1801802210
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WILSON WAY STE 500
SMYRNA GA
30082
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 770-432-1621
  • Fax: 800-722-3599
Mailing address:
  • Phone: 813-318-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS A. CANERIS
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-627-7100