Provider Demographics
NPI:1619359270
Name:TMT PHARMACEUTICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:TMT PHARMACEUTICAL MANAGEMENT, LLC
Other - Org Name:ADVANCED RX PHARMACY 031
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAINOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-621-2900
Mailing Address - Street 1:4683 CHABOT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3830
Mailing Address - Country:US
Mailing Address - Phone:925-621-2900
Mailing Address - Fax:925-522-2930
Practice Address - Street 1:407 BALTIMORE PIKE
Practice Address - Street 2:SUITE B
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1042
Practice Address - Country:US
Practice Address - Phone:925-621-2900
Practice Address - Fax:925-522-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy