Healthcare Provider Details

I. General information

NPI: 1982637567
Provider Name (Legal Business Name): PHARMERICA DRUG SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 US HIGHWAY 23 N SUITE B
WEBER CITY VA
24290-6112
US

IV. Provider business mailing address

PO BOX 409244
ATLANTA GA
30384-9244
US

V. Phone/Fax

Practice location:
  • Phone: 276-386-3700
  • Fax: 276-386-6466
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateVA

VIII. Authorized Official

Name: PEBBLES PANGRAZIO
Title or Position: CONTRACT ADMINISTRATOR
Credential:
Phone: 877-975-2273