# TRI STATE PHARMACEUTICAL SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154308625
- **Authorized official:** MICHAEL STRINGER RPH (VP)
- **Authorized official phone:** (334) 793-1316

## Contact information

- **Practice address:** 4119 W MAIN ST, DOTHAN, AL 36305-1023
- **Practice address phone:** (334) 793-1316
- **Practice address fax:** (334) 793-4920
- **Mailing address:** 4119 W MAIN ST, DOTHAN, AL 36305-1023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 111313 | AL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/27/2005
- **Last updated:** 01/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0116839 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 01 | — | 051555957 | MEDICARE CAHABA GBA-AL PART B | AL |
| 05 | — | 100003015 | — | AL |