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General NPI Number Information
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NPI Number | 1841275260
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Entity Type | Organization
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Legal Business Name | TRIPHARMA INC.
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 113 BOYER AVE
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City | LINCOLN
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State | AR
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Zip | 72744
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Country | US
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Telephone | 479-824-3256
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Fax | 479-824-4321
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Provider Business Mailing Address
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Address Line | PO BOX 888
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City | LINCOLN
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State | AR
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Zip | 72744-0888
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Country | US
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Telephone | 479-824-3256
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Fax | 479-824-4321
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. LUKE HALL
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Credential | PHARMD
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Telephone | 479-824-3256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | AR20404
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License Number State | AR
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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 | AR20404
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 20404
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License Number State | AR
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