1669978227 NPI number — TRIPLEFIN PHARMACY SERVICES LLC

Table of content: KARELYS DIAZ RIVERA M.D. (NPI 1154510774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669978227 NPI number — TRIPLEFIN PHARMACY SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIPLEFIN PHARMACY SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669978227
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11333 CORNELL PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE ASH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-1813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-878-2115
Provider Business Mailing Address Fax Number:
877-788-4942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11333 CORNELL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE ASH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-878-2115
Provider Business Practice Location Address Fax Number:
877-788-4942
Provider Enumeration Date:
04/03/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MARINAKIS
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST IN CHARGE
Authorized Official Telephone Number:
513-878-2115

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PMY.022854450-1 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2176918 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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