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General NPI Number Information
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NPI Number | 1073546651
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Entity Type | Organization
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Legal Business Name | PHARMERICA LONG-TERM CARE LLC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 4171 N MESA ST SUITE 210A
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City | EL PASO
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State | TX
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Zip | 79902
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Country | US
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Telephone | 915-545-1955
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Fax | 915-545-2168
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Provider Business Mailing Address
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Address Line | 3802 CORPOREX PARK DR STE 150
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City | TAMPA
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State | FL
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Zip | 33619-1135
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Country | US
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Telephone | 813-318-6039
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | ALLISON L. BROWN
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Credential |
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Telephone | 502-630-7429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 19294
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License Number State | TX
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