Provider Demographics
NPI:1639437783
Name:TRIAD ISOTOPES INC
Entity Type:Organization
Organization Name:TRIAD ISOTOPES INC
Other - Org Name:TRIAD ISOTOPES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, FINANCE &ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-455-6700
Mailing Address - Street 1:613 STEPHENSON AVE
Mailing Address - Street 2:STE 108
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5986
Mailing Address - Country:US
Mailing Address - Phone:912-355-8020
Mailing Address - Fax:912-355-3685
Practice Address - Street 1:613 STEPHENSON AVE
Practice Address - Street 2:STE 108
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5986
Practice Address - Country:US
Practice Address - Phone:912-355-8020
Practice Address - Fax:912-355-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336S0011X
GAPHNU0076903336N0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336N0007XSuppliersPharmacyNuclear Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134869OtherPK