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General NPI Number Information
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NPI Number | 1194279604
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Entity Type | Organization
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Legal Business Name | T & G HEALTHCARE, INC.
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 3948 PECK RD STE. A1
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City | EL MONTE
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State | CA
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Zip | 91732-2255
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Country | US
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Telephone | 626-448-2507
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Fax | 626-448-2576
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Provider Business Mailing Address
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Address Line | 24031 MARGUERITE PKWY STE A
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1929
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Country | US
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Telephone | 949-586-1700
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Fax | 949-586-4683
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Authorized Official
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Title or Position | CEO
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Name | DR. KHANH-LONG THAI
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Credential | PHARM.D.
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Telephone | 949-586-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY 54479
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY 54479
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY 54479
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License Number State | CA
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