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NPI Code Detail

MEDICARE: TAN THAI INC

MEDICARE: TAN THAI INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy
33336C0003XCommunity/Retail Pharmacy021330450OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12078707OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093812927
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAN THAI INC
Provider Business Mailing Address
First Line : 978 GALLOWAY RD
Second Line :
City : GALLOWAY
State : OH
Zip : 43119-8293
Country : US
Telephone Number : 614-853-3498
Fax Number : 614-853-4022
Provider Business Practice Location Address
First Line : 978 GALLOWAY RD
Second Line :
City : GALLOWAY
State : OH
Zip : 43119-8293
Country : US
Telephone Number : 614-853-3498
Fax Number : 614-853-4022
Authorized Official
Title or Position : PRESIDENT, OWNER, PIC, AO
Name : TAN THAI
Credential :
Telephone Number : 614-853-3498
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/19/2019

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Directions to “TAN THAI INC ” Practice Location

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