Healthcare Provider Details

I. General information

NPI: 1649071234
Provider Name (Legal Business Name): HIEU-ANDIE HOANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDIE HOANG PHARMD

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARFIELD ST STE 550
DENVER CO
80209-3392
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-5456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0024971
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: