Tri-State RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60005757A Issued in IN

Legal business name

TRI-STATE RX LLC

Practice address

4849 Pollack Ave
Evansville, IN 47715-5750

Phone

(812) 962-4664

Fax

(812) 962-4660

NPI assigned

Sep 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Nation, RPH BS

Title

Owner

Phone

(270) 684-5398

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NATIONS MEDICINES Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1184728131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 BURLEW BLVD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036486",
            "telephone_number": "270-684-5398",
            "fax_number": "270-683-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 POLLACK AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477155750",
            "telephone_number": "812-962-4664",
            "fax_number": "812-962-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "NATION",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-684-5398",
        "authorized_official_credential": "RPH BS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005757A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2024675",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200455200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NATIONS MEDICINES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tri-State Orthopaedic Surgeons, Inc.
• Tri-State Orthopaedic Surgeons, Inc.
• Tri-State Pathology Associates, LLP
• Tri-State Pediatric Associates LLC
• Tri-State Radiation Oncology Centers LLC
• Tri-State RX LLC
• Tri-State Transitional Living Inc.
• Daniela Andrea Trice, PT
• Craig Albert Triola, M.D.
• Tristate Assoc of Internal Medicine

• All providers in Evansville, IN
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.