# TRI-STATE PHARMACEUTICAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Tri-State Pharmaceutical LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649633686
- **Authorized official:** CHARLES BREE (PRINCIPAL)
- **Authorized official phone:** (888) 475-0761

## Contact information

- **Practice address:** 317 BRICK BLVD STE 100, BRICK, NJ 08723-6031
- **Practice address phone:** (888) 475-0761
- **Practice address fax:** (848) 228-2239
- **Mailing address:** 317 BRICK BLVD STE 100, BRICK, NJ 08723-6031
- **Mailing address phone:** (888) 475-0761
- **Mailing address fax:** (848) 228-2239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 28RS00735400 | NJ | Yes |

## Other

- **Enumeration date:** 03/29/2016
- **Last updated:** 07/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0547174 | — | NJ |
| 01 | — | 2159478 | PK | — |