Tri-Phasic Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

22576 Issued in TX

Legal business name

TRI-PHASIC PHARMACY, INC.

Practice address

1700 Tech Centre Pkwy
Suite #110-A1
Arlington, TX 76014-4405

Phone

(817) 784-2400

Fax

(817) 676-9147

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Ayesha Siddiqi

Title

Account Coordinator

Phone

(817) 784-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689676488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TECH CENTRE PKWY",
            "address_2": "SUITE #110-A1",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760144405",
            "telephone_number": "817-784-2400",
            "fax_number": "817-676-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TECH CENTRE PKWY",
            "address_2": "SUITE #110-A1",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760144405",
            "telephone_number": "817-784-2400",
            "fax_number": "817-676-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-PHASIC PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "ACCOUNT COORDINATOR",
        "authorized_official_telephone_number": "817-784-2400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "22576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4537152",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.