Provider Demographics
NPI:1619309127
Name:TRIO PHARMACY LLC
Entity Type:Organization
Organization Name:TRIO PHARMACY LLC
Other - Org Name:TRIO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IJEOMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:NNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-298-8180
Mailing Address - Street 1:1570 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2755
Mailing Address - Country:US
Mailing Address - Phone:614-298-8180
Mailing Address - Fax:614-298-8184
Practice Address - Street 1:1570 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2755
Practice Address - Country:US
Practice Address - Phone:614-298-8180
Practice Address - Fax:614-298-8184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X, 261QM2500X, 332B00000X, 332BP3500X
OH0223258003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141496OtherPK
OH0091539Medicaid