Organization
TRISONS PHARMACY LLC
Active
Other names
TRISONS PHARMACY & COMPOUND CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CANZANESE (MANAGER)
(484) 472-6561
Entity
Organization
Contact information
Practice address
107 RUTGERS AVE # S-1, SWARTHMORE, PA 19081-1731
(484) 472-6561
(484) 472-6562
Mailing address
107 RUTGERS AVE STE 1, SWARTHMORE, PA 19081-1725
(484) 472-6561
(484) 472-6562
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PP482287
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3997472
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/01/2012
Last updated
08/21/2012
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