Tri-State Pharmaceutical LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

28RS00735400 Issued in NJ

Legal business name

TRI-STATE PHARMACEUTICAL LLC

Practice address

317 Brick Blvd Ste 100
Brick, NJ 08723-6031

Phone

(888) 475-0761

Fax

(848) 228-2239

NPI assigned

Mar 29, 2016

Organization subpart

No

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

Authorized official

Name

Charles Bree

Title

Principal

Phone

(888) 475-0761

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tri-State Pharmaceutical LLC Doing business as

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1649633686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 BRICK BLVD STE 100",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236031",
            "telephone_number": "888-475-0761",
            "fax_number": "848-228-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BRICK BLVD STE 100",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236031",
            "telephone_number": "888-475-0761",
            "fax_number": "848-228-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE PHARMACEUTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "BREE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "888-475-0761"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NJ",
            "license": "28RS00735400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159478",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0547174",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-State Pharmaceutical LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tri-State Pharmaceutical LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Lynn Tracy
• Richard A Trainor, MS LAT ATC
• Duc Thi Tran, M.D.
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• Timothy J Trego, LDO, ABOC-AC, NCLEC
• Trinity Rehab Brick, P.a.
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• William J Trub, LCSW
• Jessica Truisi
• TS Adult Enrichment Services LLC

• Long Term Care Pharmacy in Brick, NJ
• Providers in Brick, NJ by specialty
• Long Term Care Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.