Organization
TRI STATE RX, LLC
Active
Organization
TRI STATE RX, LLC
Active
Other names
Nation's Medicines
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ALLEN HAYWOOD RPH (PHARMACY MANAGER)
(812) 962-4664
Entity
Organization
Contact information
Practice address
4849 POLLACK AVE, EVANSVILLE, IN 47715-5750
(812) 962-4664
(812) 962-4660
Mailing address
3030 BURLEW BLVD, OWENSBORO, KY 42303-6486
(270) 685-4931
(270) 685-5742
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
200460670A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200460670A
—
IN
Enumeration date
08/25/2008
Last updated
08/25/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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