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General NPI Number Information
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NPI Number | 1972057248
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Entity Type | Organization
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Legal Business Name | PHARMACY CORPORATION OF AMERICA
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 6330 E 75TH ST STE 322
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2777
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Country | US
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Telephone | 800-678-7575
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Fax | 317-595-6283
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Provider Business Mailing Address
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Address Line | PO BOX 409244
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City | ATLANTA
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State | GA
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Zip | 30384-9244
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Country | US
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Telephone | 813-378-6274
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Fax | 813-318-6346
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THOMAS A CANERIS
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Credential |
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Telephone | 502-627-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 60005275A
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License Number State | IN
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