# PHARMERICA MIDWEST LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHARMERICA CORPORATION
- **Other names:** PharMerica
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184634347
- **Legal business name:** PHARMERICA CORPORATION
- **Authorized official:** MR. THOMAS A. CANERIS (VICE PRESIDENT)
- **Authorized official phone:** (502) 627-7100

## Contact information

- **Practice address:** 4105 WESTCOR COURT, SUITE 1, CORALVILLE, IA 52241
- **Practice address phone:** (319) 545-7090
- **Practice address fax:** (319) 545-7095
- **Mailing address:** PO BOX 409244, ATLANTA, GA 30384-9244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 1206 | IA | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 01/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0498048 | — | IA |