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
2950 E MAGIC VIEW DR STE 190, MERIDIAN, ID 83642
(208) 887-1951
(208) 895-9825
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 627-7000
(502) 627-7401
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
1929LS
ID
Other
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
Enumeration date
08/13/2006
Last updated
02/13/2024
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