Healthcare Provider Details

I. General information

NPI: 1639608458
Provider Name (Legal Business Name): PCA-CORRECTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7172 LAKEVIEW PARKWAY WEST DR
INDIANAPOLIS IN
46268-4104
US

IV. Provider business mailing address

303 N HURSTBOURNE PKWY STE 200
LOUISVILLE KY
40222-5158
US

V. Phone/Fax

Practice location:
  • Phone: 866-308-2312
  • Fax: 866-936-1517
Mailing address:
  • Phone: 800-445-8917
  • Fax: 800-445-8918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number60006609A
License Number StateIN

VIII. Authorized Official

Name: CRISTINA PIETROWSKI
Title or Position: EVP, CHIEF LEGAL OFFICER & SECRETAR
Credential:
Phone: 502-412-5847