Provider Demographics
NPI:1467744961
Name:TAH FAMILY CORP
Entity Type:Organization
Organization Name:TAH FAMILY CORP
Other - Org Name:NOLANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELA
Authorized Official - Middle Name:DELPHINE
Authorized Official - Last Name:NJIKE TAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:704-817-8080
Mailing Address - Street 1:10707 PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-0107
Mailing Address - Country:US
Mailing Address - Phone:704-817-8080
Mailing Address - Fax:704-817-7661
Practice Address - Street 1:10707 PARK RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-0107
Practice Address - Country:US
Practice Address - Phone:704-817-8080
Practice Address - Fax:704-817-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy