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NPI Code Detail

MEDICARE: GIANG THI NGO

MEDICARE: GIANG THI NGO
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
1183500000XPharmacist302029648MI
2183500000XPharmacist5302029648MI

General Provider Information

NPI Number : 1750986857
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIANG THI NGO
Provider Business Mailing Address
First Line : 4325 BRETON RD SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49512-3820
Country : US
Telephone Number : 616-281-5442
Fax Number : 616-281-6931
Provider Business Practice Location Address
First Line : 4325 BRETON RD SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49512-3820
Country : US
Telephone Number : 616-281-5442
Fax Number : 616-281-6931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2020
Last Update Date : 12/04/2020

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Directions to “ GIANG THI NGO ” Practice Location

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