Provider Demographics
NPI:1609525187
Name:T & C CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:T & C CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:THAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:260-593-2252
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:IN
Mailing Address - Zip Code:46571-0157
Mailing Address - Country:US
Mailing Address - Phone:260-593-2252
Mailing Address - Fax:260-593-2150
Practice Address - Street 1:101 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571-0157
Practice Address - Country:US
Practice Address - Phone:260-593-2252
Practice Address - Fax:260-593-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty