Provider Demographics
NPI:1700882768
Name:TRI-PALM PHARMACY INC.
Entity Type:Organization
Organization Name:TRI-PALM PHARMACY INC.
Other - Org Name:PINE ISLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:PINTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-283-2141
Mailing Address - Street 1:10484 STRINGFELLOW RD
Mailing Address - Street 2:STE 2
Mailing Address - City:ST JAMES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33956-3208
Mailing Address - Country:US
Mailing Address - Phone:239-283-2141
Mailing Address - Fax:239-283-2301
Practice Address - Street 1:10484 STRINGFELLOW RD
Practice Address - Street 2:STE 2
Practice Address - City:ST JAMES CITY
Practice Address - State:FL
Practice Address - Zip Code:33956-3208
Practice Address - Country:US
Practice Address - Phone:239-283-2141
Practice Address - Fax:239-283-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH9518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty