Organization
PHARMERICA MOUNTAIN LLC
Active
Parent organization
PHARMERICA CORPORATION
Other names
PharMerica
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHARMERICA CORPORATION
Authorized official
MR. ALLISON L. BROWN (SECRETARY)
(502) 630-7429
Entity
Organization
Contact information
Practice address
3825 W CHEYENNE AVE # 603, NORTH LAS VEGAS, NV 89032-3408
(702) 871-1920
(702) 871-4203
Mailing address
3802 CORPOREX PARK DR, STE 150, TAMPA, FL 33619-1125
(813) 318-6039
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH01635
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003702002
—
NV
01
—
10562714-1708
BOARD OF PHARMACY
UT
01
—
10562714-8913
CONTROLLED SUBSTANCE
UT
01
—
11465757-1708
BOARD OF PHARMACY
UT
01
—
11465757-8913
BOARD OF PHARMACY
UT
05
—
3000009
—
UT
01
—
PHC01635
BOARD OF PHARMACY
NV
Enumeration date
07/22/2006
Last updated
02/13/2024
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