Organization
TRI STATE PHARMACEUTICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STRINGER RPH (VP)
(334) 793-1316
Entity
Organization
Contact information
Practice address
4119 W MAIN ST, DOTHAN, AL 36305-1023
(334) 793-1316
(334) 793-4920
Mailing address
4119 W MAIN ST, DOTHAN, AL 36305-1023
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111313
AL
3336C0004X
Compounding Pharmacy
—
—
Other
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
Enumeration date
12/27/2005
Last updated
01/17/2018
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