# PHARMERICA DRUG SYSTEMS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHARMERICA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912930587
- **Authorized official:** PEBBLES PANGRAZIO (CONTRACT ADMINISTRATOR)
- **Authorized official phone:** (877) 975-2273

## Contact information

- **Practice address:** 8211 USTICK RD, BOISE, ID 83704-5756
- **Practice address phone:** (208) 323-1086
- **Practice address fax:** (208) 323-5904
- **Mailing address:** PO BOX 409244, ATLANTA, GA 30384-9244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 1814LS | ID | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0230401 | — | MT |
| 01 | — | 1307405 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | PH521ID | — | AK |