Healthcare Provider Details

I. General information

NPI: 1942798103
Provider Name (Legal Business Name): TRISTAR PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 EAST TREMONT AVE
BRONX NY
10461-5707
US

IV. Provider business mailing address

3225 EAST TREMONT AVE
BRONX NY
10461-5707
US

V. Phone/Fax

Practice location:
  • Phone: 718-829-5100
  • Fax: 718-829-5600
Mailing address:
  • Phone: 718-829-5100
  • Fax: 718-829-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number036552
License Number StateNY

VIII. Authorized Official

Name: UZMA NAEEM
Title or Position: PRESIDENT
Credential:
Phone: 718-829-5100