Healthcare Provider Details

I. General information

NPI: 1083622989
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 KOAPAKA ST SUITE H-425
HONOLULU HI
96819-1800
US

IV. Provider business mailing address

3375 KOAPAKA ST SUITE H-425
HONOLULU HI
96819-1800
US

V. Phone/Fax

Practice location:
  • Phone: 808-592-2222
  • Fax: 808-592-2255
Mailing address:
  • Phone: 800-592-2222
  • Fax: 800-592-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPWD76
License Number StateHI

VIII. Authorized Official

Name: MR. ALLISON L. BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429