Healthcare Provider Details

I. General information

NPI: 1033151600
Provider Name (Legal Business Name): T MED PRODUCTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1946 S DOBSON RD SUITE 3 - 5
MESA AZ
85202-5659
US

IV. Provider business mailing address

1946 S DOBSON RD SUITE 3 - 5
MESA AZ
85202-5659
US

V. Phone/Fax

Practice location:
  • Phone: 480-345-2555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberY03731
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GARY TROILO
Title or Position: PRESIDENT
Credential:
Phone: 480-345-2555