MEDICARE: TEHAMA PHARMACY AND TRADING COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1871156497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEHAMA PHARMACY AND TRADING COMPANY

Provider Business Mailing Address
First Line	:	401 WALNUT ST
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-3319
Country	:	US
Telephone Number	:	530-527-4636
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 WALNUT ST
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-3319
Country	:	US
Telephone Number	:	530-527-4636
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BIANCA BRADSHAW
Credential	:
Telephone Number	:	530-527-4636

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	10/31/2023

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