Organization
TIFFANY THU, INC.
Active
Other names
King Pharmacy & DME
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY THU LAM (PRESIDENT)
(408) 347-0193
Entity
Organization
Contact information
Practice address
2323 MONTPELIER DR STE D, SAN JOSE, CA 95116-1611
(408) 347-0193
Mailing address
2323 MONTPELIER DR STE D, SAN JOSE, CA 95116-1611
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA451980
—
CA
Enumeration date
03/16/2018
Last updated
03/16/2018
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