Provider Demographics
NPI:1740905561
Name:TO, TUYET-TRINH T (PHARMD)
Entity type:Individual
Prefix:
First Name:TUYET-TRINH
Middle Name:T
Last Name:TO
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 1:5831 EAGLES FEATHER LN
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-5278
Mailing Address - Country:US
Mailing Address - Phone:678-756-3121
Mailing Address - Fax:
Practice Address - Street 1:1101 N PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4209
Practice Address - Country:US
Practice Address - Phone:770-486-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty