Healthcare Provider Details

I. General information

NPI: 1265465843
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

83 VERMONT AVE UNIT 2
WARWICK RI
02888-3047
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 401-737-4165
  • Fax: 401-739-9770
Mailing address:
  • Phone: 813-318-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHA00264
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHA00446
License Number StateRI

VIII. Authorized Official

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