MEDICARE: PHARMACY CORPORATION OF AMERICA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9696-42	OTHER	WI	BOARD OF PHARMACY

General Provider Information

NPI Number	:	1124665336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY CORPORATION OF AMERICA

Provider Business Mailing Address
First Line	:	11739 W BRADLEY RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224
Country	:	US
Telephone Number	:	888-210-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	11739 W BRADLEY RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-2531
Country	:	US
Telephone Number	:	888-210-5906
Fax Number	:	877-583-0109

Authorized Official
Title or Position	:	SECRETARY
Name	:	ALLISON L. BROWN
Credential	:
Telephone Number	:	502-630-7429

Provider Enumeration Date	:	12/06/2019
Last Update Date	:	02/13/2024

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Directions to “PHARMACY CORPORATION OF AMERICA ” Practice Location

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