Provider Demographics
NPI:1568477180
Name:T & G HEALTHCARE INC
Entity Type:Organization
Organization Name:T & G HEALTHCARE INC
Other - Org Name:EL MONTE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KHANH-LONG
Authorized Official - Middle Name:
Authorized Official - Last Name:THAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:626-448-2507
Mailing Address - Street 1:3948 PECK RD
Mailing Address - Street 2:SUITE A1-A2
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2255
Mailing Address - Country:US
Mailing Address - Phone:626-448-2507
Mailing Address - Fax:626-448-2576
Practice Address - Street 1:3948 PECK RD
Practice Address - Street 2:SUITE A1-A2
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2255
Practice Address - Country:US
Practice Address - Phone:626-448-2507
Practice Address - Fax:626-448-2576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
CAPHY489583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1568477180Medicaid
2114106OtherPK
2114106OtherPK