Provider Demographics
NPI:1811082340
Name:TRIANGLE PHARMACY INC.
Entity type:Organization
Organization Name:TRIANGLE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:DRNJEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-296-8508
Mailing Address - Street 1:219 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266
Mailing Address - Country:US
Mailing Address - Phone:330-296-8508
Mailing Address - Fax:330-296-5284
Practice Address - Street 1:219 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266
Practice Address - Country:US
Practice Address - Phone:330-296-8508
Practice Address - Fax:330-297-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OH02-6912003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0870473Medicaid
OH0683080001Medicare NSC
OH0683080001Medicare NSC