Provider Demographics
NPI:1164866208
Name:TANG PHARMACY V INC
Entity Type:Organization
Organization Name:TANG PHARMACY V INC
Other - Org Name:TANG PHARMACY V
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-704-1222
Mailing Address - Street 1:7452 OGONTZ AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-1324
Mailing Address - Country:US
Mailing Address - Phone:215-548-1800
Mailing Address - Fax:215-548-1801
Practice Address - Street 1:7452 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-1324
Practice Address - Country:US
Practice Address - Phone:215-548-1800
Practice Address - Fax:215-548-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4823633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140032OtherPK