Healthcare Provider Details

I. General information

NPI: 1609809284
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

25316 74TH AVENUE S STE 105
KENT WA
98032
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 800-562-8386
  • Fax: 425-251-3270
Mailing address:
  • Phone: 813-318-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHAR.CF.00056046
License Number StateWA

VIII. Authorized Official

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