Tri-Valley Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP414494-L Issued in PA

Legal business name

TRI-VALLEY PHARMACY, INC.

Doing business as

Tri-Valley Pharmacy #1

Practice address

7 W Main St
Tremont, PA 17981-1707

Phone

(570) 695-3120

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey D. Kline

Title

President

Phone

(570) 695-3120

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tri-Valley Pharmacy #1 Doing business as

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760481923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "VALLEY VIEW",
            "state": "PA",
            "postal_code": "179830186",
            "telephone_number": "570-695-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W MAIN ST",
            "city": "TREMONT",
            "state": "PA",
            "postal_code": "179811707",
            "telephone_number": "570-695-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VALLEY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-695-3120",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP414494-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007504240004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Valley Pharmacy #1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Tremont, PA
• Providers in Tremont, PA by specialty
• Pharmacy in Pennsylvania

• 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.