# PHARMERICA MOUNTAIN LLC

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

## Provider details

- **NPI number:** 1760494033
- **Legal business name:** PHARMERICA CORPORATION
- **Authorized official:** MR. ALLISON L. BROWN (SECRETARY)
- **Authorized official phone:** (502) 630-7429

## Contact information

- **Practice address:** 2950 E MAGIC VIEW DR STE 190, MERIDIAN, ID 83642
- **Practice address phone:** (208) 887-1951
- **Practice address fax:** (208) 895-9825
- **Mailing address:** 805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
- **Mailing address phone:** (502) 627-7000
- **Mailing address fax:** (502) 627-7401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 1929LS | ID | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 02/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1704147 | — | AK |
| 05 | — | 276268 | — | OR |
| 01 | — | 47154LS | BOARD OF PHARMACY | ID |
| 05 | — | 6022362 | — | WA |
| 05 | — | 807106500 | — | ID |
| 01 | — | RP-0002900 | BOARD OF PHARMACY | OR |