MEDICARE: VICTOR NGUYEN

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	1-16820	KS

General Provider Information

NPI Number	:	1457768947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR NGUYEN

Provider Business Mailing Address
First Line	:	1625 S WEBB RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207-5601
Country	:	US
Telephone Number	:	316-652-9147
Fax Number	:	316-652-9178

Provider Business Practice Location Address
First Line	:	1625 S WEBB RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67207-5601
Country	:	US
Telephone Number	:	316-652-9147
Fax Number	:	316-652-9178

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

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	07/21/2014

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Directions to “ VICTOR NGUYEN ” Practice Location

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