PHARMERICA LONG TERM CARE LLC (NPI# 1811920499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811920499 |
| Entity Type | Organization |
| Organization Name | PHARMERICA LONG TERM CARE LLC |
| Other Organization Name | PHARMERICA |
| Practice Address |
625 Central Ave W Suite 105 Great Falls MT 59404-2874 |
| Mailing Address |
3802 Corporex Park Dr Ste 200 Tampa FL 33619-1125 |
| Practice Telephone | 8007573713 |
| Practice Fax Number | 8002951662 |
| Mailing Telephone | 8133186039 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-10-08 |
| NPI Deactivation Date | 06/11/2018 |
| NPI Reactivation Date | 2019-01-23 |
| Authorized Official Name | STEVEN S. REED (VICE PRESIDENT) |
| Authorized Official Telephone | 5023942100 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHARMERICA CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 1065 | MT | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
1065 | MT | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
1229 | MT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1811920499 | 05 | |
| MT | BOARD OF PHARMACY | PHA-PHR-LIC-58716 | 01 |
| MT | DEA | FP8229812 | 01 |
| Other Name | Type Code |
|---|---|
| PHARMERICA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639102213 | Pharmerica Long Term Care LLC | Pharmacy | 2720 Broadbent Pkwy Ne Ste A, Albuquerque, NM 87107 | 2006-07-08 |
| 1073546651 | Pharmerica Long Term Care LLC | Pharmacy | 4171 N Mesa St, Suite 210a, El Paso, TX 79902 | 2006-07-08 |
| Street Address |
625 CENTRAL AVE W SUITE 105 |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59404-2874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336674548 | David Houston Rushing | Pharmacist | 625 Central Ave W, Sutie 105, Great Falls, MT 59404-2874 | 2017-04-25 |
| 1376834440 | Debra L Thurman | Social Worker | 625 Central Ave W, Suite #205, Great Falls, MT 59404-2874 | 2011-04-25 |
| 1881920197 | Andrew Edward Gawlikowski | Pharmacist | 625 Central Ave W, Suite 105, Great Falls, MT 59404-2874 | 2009-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629504154 | Shawna Renee Applegate | Nurse Practitioner | 115 4th St S., Great Falls, MT 59404 | 2017-05-03 |
| 1093267213 | Cara Firman | Counselor | 3300 3rd St Ne, Great Falls, MT 59404 | 2016-11-04 |
| 1457803900 | Benjamin Huempfner | Counselor | 1205 1st Ave Nw, Great Falls, MT 59404 | 2016-11-01 |
| 1649675471 | Stephen Trautman | Pharmacist | 1000 3rd Steet Nw, Great Falls, MT 59404 | 2014-10-22 |
| 1457765851 | Complete Eye Care Pllc | Optometrist | 1012 1st Ave Nw, Great Falls, MT 59404 | 2014-06-13 |
| 1871923714 | William Joshu | Physician Assistant | 25 14th Avenue N.w., Great Falls, MT 59404 | 2013-11-13 |
| 1679839369 | Joelene Sharon (o'neill) Goodover | Counselor | 803 Forest Ave., Great Falls, MT 59404 | 2012-04-06 |
| 1942512728 | Amy Jo Jamieson | Counselor | 600 Ave. A, Valley View School, Great Falls, MT 59404 | 2010-07-08 |
| 1942527890 | Matthew Clayton Taecker | Emergency Medicine | 113 38th Ave Ne, Great Falls, MT 59404 | 2010-04-30 |
| 1720212897 | Dana Marie Thompson | Military Health Care Provider | 819 Rhs/sg, 6944 Goddard Drive, Malmstrom Afb, MT 59404 | 2009-05-05 |
| Find all providers in zip 59404 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902390404 | Big Sky Managed Care | Pharmacy | 900 13th Ave S, Great Falls, MT 59405-4426 | 2018-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641069 | Glacier Pharmacy LLC | Pharmacy | 601 W Main St Ste 1a, Cut Bank, MT 59427-2832 | 2019-07-17 |
| 1104325372 | Pintler Pharmacy Inc. | Pharmacy | 203 East Park, Anaconda, MT 59711 | 2018-02-02 |
| 1770005811 | Big Sky Managed Care | Pharmacy | 900 Jackson St Ste A, Helena, MT 59601 | 2017-07-11 |
| 1174945406 | Healthcare Providers-ltc | Pharmacy | 1900 N 1st St Ste B, Hamilton, MT 59840-3115 | 2014-01-06 |
| 1659504363 | Glacier Ridge Pharmacy Inc | Pharmacy | 6475 Us Highway 93 S, Whitefish, MT 59937-8282 | 2009-08-27 |
| 1205062098 | Glacier Ridge Pharmacy Inc | Pharmacy | 55 1st Avenue East N, Kalispell, MT 59901-4001 | 2009-06-07 |
| 1790804557 | Mt State Veterans Home Satelite Pharmacy | Pharmacy | 400 Veterans Road, Columbia Falls, MT 59912-0250 | 2007-03-29 |
| 1851424246 | Three Bears Alaska Inc | Pharmacy | 45 Three Bears Dr, Butte, MT 59701 | 2007-03-14 |
| 1164559746 | Pharmfill Inc | Pharmacy | 117 N Main St # A, Three Forks, MT 59752-9013 | 2007-02-28 |
| 1902942469 | Granite Cnty Med Hosp Phcy | Pharmacy | 310 Sansome St, Philipsburg, MT 59858-0729 | 2007-01-30 |
| Find all providers with the same taxonomy | ||||
| City | GREAT FALLS |
| Zip Code | 59404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.