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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0004X	Compounding Pharmacy	LSC99439	CA
3	3336L0003X	Long Term Care Pharmacy	PHY48699	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0533679	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679506240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY CORPORATION OF AMERICA

Provider Business Mailing Address
First Line	:	3802 CORPOREX PARK DR
Second Line	:	STE 150
City	:	TAMPA
State	:	FL
Zip	:	33619-1125
Country	:	US
Telephone Number	:	813-318-6039
Fax Number	:

Provider Business Practice Location Address
First Line	:	32980 ALVARADO NILES RD
Second Line	:	SUITE 836/846
City	:	UNION CITY
State	:	CA
Zip	:	94587-8104
Country	:	US
Telephone Number	:	800-660-9063
Fax Number	:	510-477-4390

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	02/13/2024

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Directions to “PHARMACY CORPORATION OF AMERICA ” Practice Location

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