Organization
PHARMERICA MIDWEST LLC
Active
Parent organization
PHARMERICA CORPORATION
Other names
PharMerica
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHARMERICA CORPORATION
Authorized official
MR. THOMAS A. CANERIS (VICE PRESIDENT)
(502) 627-7100
Entity
Organization
Contact information
Practice address
4105 WESTCOR COURT, SUITE 1, CORALVILLE, IA 52241
(319) 545-7090
(319) 545-7095
Mailing address
PO BOX 409244, ATLANTA, GA 30384-9244
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336L0003X
Long Term Care Pharmacy
Primary
1206
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0498048
—
IA
Enumeration date
08/09/2006
Last updated
01/22/2010
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