Tri-Care Inc
Organization Active NPI Community/Retail Pharmacy · Reidsville, GA
NPI 1720160666 · NPPES record last updated Dec 19, 2016
Key facts
- NPI
- 1720160666
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE008101 (GA)
- Legal business name
- TRI-CARE INC
- Practice address
- 214 S Main St
Reidsville, GA 30453-4602 - Phone
- (912) 557-4701
- Fax
- (912) 557-6078
- NPI assigned
- Oct 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Frank Toole, RPH
- Title
- Owner
- Phone
- (912) 557-4701
Practitioners 2
-
Frank Danny Toole, R.PH.
-
Connor Dale Willyard, PHARM D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930015402 | GA | DME Supplier - Pharmacy |
8224159884 | Practice locations: Reidsville, GA |
| O20130827000264 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8224159884 | Practice locations: Reidsville, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHRE008101 | GA | Yes |
Addresses
Primary practice location
214 S Main St
Reidsville, GA 30453-4602
Mailing address
PO Box 159
Reidsville, GA 30453-0159
Phone (912) 557-4701
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2019710 | Other | PK | |
| 00745775A | Medicaid | GA |
Other names
- THE DRUG STORE
Other providers in Reidsville, GA
- The Tattnall Bank
- Allyson N Thomas
- TN SNF LLC
- Frank Danny Toole
- Rebecca Towns
- Ashley Nicole Vaughan
- Volunteers of America Georgia
- Deontay Walker
- Alana Purcell Waters
- Connor Dale Willyard
All providers in Reidsville, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.