Provider Demographics
NPI:1619374006
Name:TMT INTERNATIONAL PHARMACEUTICAL CORPORATION
Entity Type:Organization
Organization Name:TMT INTERNATIONAL PHARMACEUTICAL CORPORATION
Other - Org Name:AAA COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER-PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-725-1511
Mailing Address - Street 1:7921 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4001
Mailing Address - Country:US
Mailing Address - Phone:714-988-6888
Mailing Address - Fax:714-677-2400
Practice Address - Street 1:7921 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4001
Practice Address - Country:US
Practice Address - Phone:714-988-6888
Practice Address - Fax:714-677-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
CAPHY520463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149061OtherPK