MEDICARE: ANHTHU PHAM LE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH022144	GA

General Provider Information

NPI Number	:	1356296297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANHTHU PHAM LE PHARMD

Provider Business Mailing Address
First Line	:	1750 BRIERGATE DR
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-4300
Country	:	US
Telephone Number	:	770-354-0029
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 BRIERGATE DR
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-4300
Country	:	US
Telephone Number	:	770-354-0029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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