Tyan Pharmacy & Medical Supply LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482560 Issued in PA

Legal business name

TYAN PHARMACY & MEDICAL SUPPLY LLC

Practice address

2846 Knights Rd
Bensalem, PA 19020-3552

Phone

(215) 639-9400

Fax

(215) 639-9401

NPI assigned

Jun 19, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Regina G WilliamsNPI 1578881249

Title

Pic

Phone

(215) 639-9400

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Regina G Williams, PHARMD

  • Pharmacist
  • Philadelphia, PA
  • NPI 1578881249
  NPD Authorized official
• Damien Krishna Brown, PHARMD

  • Pharmacist
  • Bensalem, PA
  • NPI 1750828265
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1962884544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 KNIGHTS RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190203552",
            "telephone_number": "215-639-9400",
            "fax_number": "215-639-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2846 KNIGHTS RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190203552",
            "telephone_number": "215-639-9400",
            "fax_number": "215-639-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYAN PHARMACY & MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "215-639-9400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482560",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030274210001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mark Tyler
• Egim Uche, PMHNP
• Iqra Uddin Rafat, OD
• Abiola Ugwuoke
• Emmanuel A Ugwuoke, M.D.

• All providers in Bensalem, PA
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.