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General NPI Number Information
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NPI Number | 1275646499
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Entity Type | Organization
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Legal Business Name | TRI-STATE COMPOUNDING PHARMACY LLC
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 7715 BEECHMONT AVE
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City | CINCINNATI
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State | OH
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Zip | 45255-4203
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Country | US
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Telephone | 513-624-7333
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Fax | 513-624-7555
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Provider Business Mailing Address
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Address Line | 7715 BEECHMONT AVE
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City | CINCINNATI
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State | OH
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Zip | 45255
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Country | US
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Telephone | 513-624-7333
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Fax | 513-624-7555
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Authorized Official
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Title or Position | OWNER,PIC,AO
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Name | CHAD THOMPSON
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Credential | RPH
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Telephone | 513-624-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 021356250-03
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | OH1934
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License Number State | KY
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