Provider Demographics
NPI:1851699094
Name:CHIANG, TINA WEI (PHARMD,)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:WEI
Last Name:CHIANG
Suffix:
Gender:F
Credentials:PHARMD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 CENTERVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6405
Mailing Address - Country:US
Mailing Address - Phone:770-736-2157
Mailing Address - Fax:770-736-9347
Practice Address - Street 1:3505 CENTERVILLE HWY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6405
Practice Address - Country:US
Practice Address - Phone:770-736-2157
Practice Address - Fax:770-736-9347
Is Sole Proprietor?:No
Enumeration Date:2011-03-12
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist