Provider Demographics
NPI:1497747125
Name:THANH PHARMACY INC
Entity Type:Organization
Organization Name:THANH PHARMACY INC
Other - Org Name:THANH PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:310-973-0321
Mailing Address - Street 1:12923 INGLEWOOD AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5139
Mailing Address - Country:US
Mailing Address - Phone:310-973-0321
Mailing Address - Fax:310-973-2432
Practice Address - Street 1:12923 INGLEWOOD AVE
Practice Address - Street 2:STE 2
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5139
Practice Address - Country:US
Practice Address - Phone:310-973-0321
Practice Address - Fax:310-973-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY488753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113531OtherPK