Provider Demographics
NPI:1558644641
Name:TAO, JANCHENG TONY (RPH)
Entity type:Individual
Prefix:MR
First Name:JANCHENG
Middle Name:TONY
Last Name:TAO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 VEIRS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2538
Mailing Address - Country:US
Mailing Address - Phone:301-692-1331
Mailing Address - Fax:301-692-1332
Practice Address - Street 1:11160 VEIRS MILL RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2538
Practice Address - Country:US
Practice Address - Phone:301-692-1331
Practice Address - Fax:301-692-1332
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist