Healthcare Provider Details

I. General information

NPI: 1285285908
Provider Name (Legal Business Name): TRIPHARMA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N PROGRESS AVE
SILOAM SPRINGS AR
72761
US

IV. Provider business mailing address

PO BOX 1095
GRAVETTE AR
72736-1095
US

V. Phone/Fax

Practice location:
  • Phone: 479-770-0111
  • Fax:
Mailing address:
  • Phone: 479-770-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JAMES GARLAND
Title or Position: MANAGER
Credential:
Phone: 479-770-0111