Provider Demographics
NPI:1639590839
Name:TRIUMPH PHARMACY LLC
Entity Type:Organization
Organization Name:TRIUMPH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOLITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-529-0300
Mailing Address - Street 1:11112 SUTPHIN BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-5829
Mailing Address - Country:US
Mailing Address - Phone:718-529-0300
Mailing Address - Fax:718-529-0321
Practice Address - Street 1:11112 SUTPHIN BLVD # 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-5829
Practice Address - Country:US
Practice Address - Phone:718-529-0300
Practice Address - Fax:718-529-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-15
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier