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NPI Code Detail

MEDICARE: MINH HA THI PHAN

MEDICARE: MINH HA THI PHAN
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
1183500000XPharmacist0015650OR

General Provider Information

NPI Number : 1922550847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINH HA THI PHAN
Provider Business Mailing Address
First Line : 4048 NE HIGHWAY 101
Second Line :
City : LINCOLN CITY
State : OR
Zip : 97367-5069
Country : US
Telephone Number : 541-994-5670
Fax Number :
Provider Business Practice Location Address
First Line : 4048 NE HIGHWAY 101
Second Line :
City : LINCOLN CITY
State : OR
Zip : 97367-5069
Country : US
Telephone Number : 541-994-5670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/26/2016

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Directions to “ MINH HA THI PHAN ” Practice Location

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