Provider Demographics
NPI:1639976541
Name:TRIPP, AUSTIN RYLEY (RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:RYLEY
Last Name:TRIPP
Suffix:
Gender:
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1829
Mailing Address - Country:US
Mailing Address - Phone:406-563-8410
Mailing Address - Fax:406-563-8438
Practice Address - Street 1:1525 W PARK AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-1829
Practice Address - Country:US
Practice Address - Phone:406-563-8410
Practice Address - Fax:406-563-8438
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT112162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist