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Contact Information

TYFAN INC.
11231 INDIAN CREEK ROAD
POUND, VA24279
 Phone: 276-796-2200
 Fax: 276-796-2202
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for TYFAN INC.

NPI # 1255381265
LBN Legal business name TYFAN INC.
Authorized official GREGORY MULLINS - (OWNER/PHARMACIST-IN-CHARGE)
Entity Organization
Organization subpart 1 No
Enumeration date 05/11/2006
Last updated 06/09/2020 - About 6 years ago
Identifiers
VA License # 0201004080
KY Medicaid 7100266980
VA Medicaid 010266238
Other 2105920 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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