Healthcare Provider Details

I. General information

NPI: 1982901419
Provider Name (Legal Business Name): PHARMACY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ARC DR
SAINT LOUIS MO
63146-3502
US

IV. Provider business mailing address

3802 CORPOREX PARK DR STE 150
TAMPA FL
33619-1135
US

V. Phone/Fax

Practice location:
  • Phone: 314-473-1340
  • Fax: 314-473-1342
Mailing address:
  • Phone: 813-318-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number054.019336
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2011003322
License Number StateMO

VIII. Authorized Official

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