Provider Demographics
NPI:1477082659
Name:CAREMORE ANAHEIM MTM PHARMA INC
Entity Type:Organization
Organization Name:CAREMORE ANAHEIM MTM PHARMA INC
Other - Org Name:MTM PHARMACY V
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA TUYET
Authorized Official - Middle Name:
Authorized Official - Last Name:QUACH-TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-613-1971
Mailing Address - Street 1:1172 N EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1900
Mailing Address - Country:US
Mailing Address - Phone:714-613-1971
Mailing Address - Fax:714-613-1975
Practice Address - Street 1:1172 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1900
Practice Address - Country:US
Practice Address - Phone:714-613-1971
Practice Address - Fax:714-613-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY57945OtherBOARD OF PHARMACY