Provider Demographics
NPI:1902136500
Name:T&N PHARMACY INC
Entity Type:Organization
Organization Name:T&N PHARMACY INC
Other - Org Name:T & N PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/SP
Authorized Official - Prefix:
Authorized Official - First Name:TEIMURAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BALACHVILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-416-4395
Mailing Address - Street 1:2570 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3505
Mailing Address - Country:US
Mailing Address - Phone:718-646-2100
Mailing Address - Fax:718-646-2101
Practice Address - Street 1:2570 E 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3505
Practice Address - Country:US
Practice Address - Phone:718-646-2100
Practice Address - Fax:718-646-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029829333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3363885OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3363885OtherNCPDP PROVIDER IDENTIFICATION NUMBER