MEDICARE: MR. LAM THANH NGUYEN RPH

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	15603	CO

General Provider Information

NPI Number	:	1952744112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAM THANH NGUYEN RPH

Provider Business Mailing Address
First Line	:	2727 W EVANS AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-5507
Country	:	US
Telephone Number	:	303-936-2377
Fax Number	:	303-937-4427

Provider Business Practice Location Address
First Line	:	2727 W EVANS AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-5507
Country	:	US
Telephone Number	:	303-936-2377
Fax Number	:	303-937-4427

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

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	04/08/2013

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