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General NPI Number Information
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NPI Number | 1578034096
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Entity Type | Organization
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Legal Business Name | TRIPLE ALLIANCE PHARMACY, INC
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 1819 WEST VIRGNIA AVENUE NE
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City | WASHINGTON DC
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State | DC
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Zip | 20002
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Country | US
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Telephone | 202-525-1386
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Fax | 202-629-4543
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Provider Business Mailing Address
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Address Line | 1819 WEST VIRGNIA AVENUE NE
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City | WASHINGTON DC
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State | DC
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Zip | 20002
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Country | US
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Telephone | 202-525-1386
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Fax | 202-629-4543
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Authorized Official
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Title or Position | SECRETARY
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Name | TSEDALE M ZERABRUK
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Credential |
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Telephone | 202-525-1386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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