Healthcare Provider Details

I. General information

NPI: 1275729097
Provider Name (Legal Business Name): TANYIFOR TOHNYA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2007
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 DAVIS DR
MORRISVILLE NC
27560-8819
US

IV. Provider business mailing address

3560 DAVIS DR
MORRISVILLE NC
27560-8819
US

V. Phone/Fax

Practice location:
  • Phone: 919-337-9872
  • Fax:
Mailing address:
  • Phone: 919-337-9872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20224
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202205195
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: