Provider Demographics
NPI:1790787265
Name:TNL PHARMACY CORPORATION
Entity Type:Organization
Organization Name:TNL PHARMACY CORPORATION
Other - Org Name:HONG'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:DOTHAI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-890-0331
Mailing Address - Street 1:8883 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2608
Mailing Address - Country:US
Mailing Address - Phone:714-890-0331
Mailing Address - Fax:714-890-1860
Practice Address - Street 1:8883 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2608
Practice Address - Country:US
Practice Address - Phone:714-890-0331
Practice Address - Fax:714-890-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 489603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790787265Medicaid
CAPHY 48960OtherPHARMACY PERMIT
CAPHY 48960OtherPHARMACY PERMIT