Organization
PHARMACY CORPORATION OF AMERICA
Active
Parent organization
PHARMACY CORPORATION OF AMERICA
Other names
WAILUKU PROFESSIONAL PHARMACY, PharMerica
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHARMACY CORPORATION OF AMERICA
Authorized official
STEPHEN A LARIVIERE (CHIEF COMPLIANCE OFFICER)
(502) 627-7404
Entity
Organization
Contact information
Practice address
1900 MAIN ST, WAILUKU, HI 96793-1900
(808) 244-9099
(808) 244-8082
Mailing address
PO BOX 409244, ATLANTA, GA 30384-9244
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY580
HI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08013401
—
HI
01
—
1202198
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/08/2006
Last updated
11/18/2019
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