# TRI-CITY PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tri-City Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275794307
- **Authorized official:** MIRANDA BASRAI PHARM. D (PHARMACIST)
- **Authorized official phone:** (510) 366-9218

## Contact information

- **Practice address:** 1132 CADILLAC CT, MILPITAS, CA 95035-3058
- **Practice address phone:** (408) 935-9120
- **Practice address fax:** (408) 935-9121
- **Mailing address:** 1132 CADILLAC CT, MILPITAS, CA 95035-3058
- **Mailing address phone:** (408) 935-9120
- **Mailing address fax:** (408) 935-9121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHY49020 | CA | — |
| 3336L0003X | Long Term Care Pharmacy | — | CA | Yes |
| 3336S0011X | Specialty Pharmacy | — | CA | — |

## Other

- **Enumeration date:** 06/20/2008
- **Last updated:** 08/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5631963 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |