Organization
GOOT NURSING HOME PHARMACY INC
Active
Parent organization
PHARMERICA CORPORATION
Other names
PHARMERICA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHARMERICA CORPORATION
Authorized official
ALLISON L. BROWN (SECRETARY)
(502) 630-7429
Entity
Organization
Contact information
Practice address
8826 N 23RD AVE, SUITE C-2, PHOENIX, AZ 85021-4154
(602) 995-1320
(602) 995-0264
Mailing address
3802 CORPOREX PARK DR, STE 150, TAMPA, FL 33619-1125
(813) 318-6039
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336L0003X
Long Term Care Pharmacy
Primary
Y02939
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199796 00
—
MD
01
—
0315538
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
100512163
—
NV
05
—
1013942051
—
CO
05
—
1013942051
—
IA
05
—
1013942051
—
MI
05
—
1013942051
—
MT
05
—
1017729270001
—
PA
05
—
200833340A
—
IN
05
—
482646
—
AZ
05
—
6058574
—
NM
Enumeration date
07/11/2006
Last updated
02/13/2024
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