NPI Code Details Logo

NPI 1619887460

NPI 1619887460 : TRIPHARMA INC : LOWELL, AR

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1619887460
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    TRIPHARMA INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/11/2026
-----------------------------------------------------
    Last Update Date     |    09/11/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    114 HARRISON AVE 
-----------------------------------------------------
    City                 |    LOWELL
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72745-9047
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    479-770-0111
-----------------------------------------------------
    Fax                  |    479-770-0113
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    114 HARRISON AVE 
-----------------------------------------------------
    City                 |    LOWELL
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72745-9047
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    479-770-0111
-----------------------------------------------------
    Fax                  |    479-770-0113
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     JOHN EARL LYKINS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    479-318-0520
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    3336L0003X
-----------------------------------------------------
    Taxonomy Name        |    Long Term Care Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.