Provider Demographics
NPI:1316264310
Name:TIN RX 806, INC.
Entity type:Organization
Organization Name:TIN RX 806, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-928-9168
Mailing Address - Street 1:3005 E. RENNER RD.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3570
Mailing Address - Country:US
Mailing Address - Phone:214-324-5100
Mailing Address - Fax:214-324-5102
Practice Address - Street 1:3005 E. RENNER RD.
Practice Address - Street 2:SUITE C
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3570
Practice Address - Country:US
Practice Address - Phone:214-324-5100
Practice Address - Fax:214-324-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX268163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146161Medicaid
2124493OtherPK