MEDICARE: DR. HALI NGOC LAI PHARM D

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	PS52149	FL

General Provider Information

NPI Number	:	1912308594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HALI NGOC LAI PHARM D

Provider Business Mailing Address
First Line	:	5764 102ND AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33782-3306
Country	:	US
Telephone Number	:	727-546-7791
Fax Number	:

Provider Business Practice Location Address
First Line	:	7333 PARK BLVD N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-2922
Country	:	US
Telephone Number	:	727-546-7791
Fax Number	:	727-545-3773

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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