Healthcare Provider Details

I. General information

NPI: 1427081009
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: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9041 W. HEATHER AVE.
MILWAUKEE WI
53224
US

IV. Provider business mailing address

3802 CORPOREX PARK DR STE 200
TAMPA FL
33619-1125
US

V. Phone/Fax

Practice location:
  • Phone: 800-477-7221
  • Fax: 800-317-9747
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 Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number8509042
License Number StateWI

VIII. Authorized Official

Name: STEVEN S. REED
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-394-2100