Tripharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

TRIPHARMA INC

Doing business as

Live Well Pharmacy

Practice address

3500 SW Regional Airport Blvd Ste 2
Bentonville, AR 72712

Phone

(479) 271-9355

Fax

(479) 770-0113

NPI assigned

Jul 13, 2018

Last updated

Jan 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John LykinsNPI 1154925543

Title

Owner

Phone

(479) 770-0111

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Live Well Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Tripharma Inc

  dba Live Well Pharmacy

  • Community/Retail Pharmacy
  • Fayetteville, AR
  • NPI 1124658141

  O20200416002353

  Same enrollment
• Tripharma Inc

  dba Lowell Pharmacy

  • Community/Retail Pharmacy
  • Lowell, AR
  • NPI 1881670818

  O20200416002353

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Lykins, PD

  • Pharmacist
  • Lowell, AR
  • NPI 1154925543
  Authorized official Same address or phone
• Luke Hall

  • Pharmacist
  • Fayetteville, AR
  • NPI 1740884147
  NPD (past)

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1609352566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1095",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727361095",
            "telephone_number": "479-271-9355",
            "fax_number": "479-271-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SW REGIONAL AIRPORT BLVD STE 2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-271-9355",
            "fax_number": "479-770-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "LYKINS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-770-0111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223890407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Well Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.