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General NPI Number Information
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NPI Number | 1124179478
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Entity Type | Organization
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Legal Business Name | T & C DRUG INC
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 1326 W OLIVE AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3034
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Country | US
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Telephone | 559-781-1925
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Fax | 559-781-8331
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Provider Business Mailing Address
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Address Line | 1326 W OLIVE AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3034
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Country | US
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Telephone | 559-781-1925
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Fax | 559-781-8331
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. FRANK GONG
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Credential |
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Telephone | 559-781-1925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY 18138
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License Number State | CA
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