Organization
PHARMERICA DRUG SYSTEMS INC
Active
Other names
PHARMERICA
Organization subpart
No
Provider details
NPI number
Authorized official
PEBBLES PANGRAZIO (CONTRACT ADMINISTRATOR)
(877) 975-2273
Entity
Organization
Contact information
Practice address
8211 USTICK RD, BOISE, ID 83704-5756
(208) 323-1086
(208) 323-5904
Mailing address
PO BOX 409244, ATLANTA, GA 30384-9244
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
1814LS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230401
—
MT
01
—
1307405
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PH521ID
—
AK
Enumeration date
07/08/2006
Last updated
08/22/2020
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