1386957207 NPI number — TANDON'S ADVANCED PHARMACY INC.

Table of content: (NPI 1386957207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386957207 NPI number — TANDON'S ADVANCED PHARMACY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TANDON'S ADVANCED PHARMACY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVANCED HEALTH PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386957207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7157 HUNTERS RDG
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49009-7779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-324-1100
Provider Business Mailing Address Fax Number:
269-324-2809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7916 OAKLAND DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTAGE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49024-4936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-324-1100
Provider Business Practice Location Address Fax Number:
269-324-2809
Provider Enumeration Date:
07/20/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TANDON
Authorized Official First Name:
ARUN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT / OWNER
Authorized Official Telephone Number:
269-271-2561

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)