Organization
TRI STAR MEDICAL PHARMACY LLC
Active
Other names
Tri Star Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NANDAN PATEL (OWNER)
(734) 673-7829
Entity
Organization
Contact information
Practice address
2845 CAPITAL AVE SW, SUITE 301, BATTLE CREEK, MI 49015-4185
(269) 979-5402
(269) 979-5609
Mailing address
2845 CAPITAL AVE SW, SUITE 301, BATTLE CREEK, MI 49015-4185
(269) 979-5402
(269) 979-5609
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009565
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2375536
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/26/2011
Last updated
07/05/2011
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