Organization
TANGO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBENSON APIBO-TANGO PHARM.D (OWNER PIC)
(702) 636-2054
Entity
Organization
Contact information
Practice address
4090 W CRAIG RD STE 101, NORTH LAS VEGAS, NV 89032-2758
(702) 636-2054
(702) 636-2028
Mailing address
PO BOX 777833, HENDERSON, NV 89077-7833
(702) 636-2054
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PH03689
NV
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PH03689
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306385877
—
NV
01
—
2168000
PK
—
Enumeration date
02/17/2017
Last updated
01/16/2023
Update your record
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