Healthcare Provider Details

I. General information

NPI: 1205227246
Provider Name (Legal Business Name): TIN RX THE INDEPENDENT NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 SOLANO STREET
CORNING CA
96021
US

IV. Provider business mailing address

1322 SOLANO STREET
CORNING CA
96021
US

V. Phone/Fax

Practice location:
  • Phone: 530-824-0800
  • Fax: 530-824-0800
Mailing address:
  • Phone: 530-824-0800
  • Fax: 530-824-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY56059
License Number StateCA

VIII. Authorized Official

Name: CHRISTINA GLENDA TONGCO GARCIA
Title or Position: FOUNDER/CEO
Credential: PHARMD
Phone: 530-824-0800