Healthcare Provider Details

I. General information

NPI: 1053033381
Provider Name (Legal Business Name): LILIAN HOANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5764 PEACHTREE INDUSTRIAL BLVD
CHAMBLEE GA
30341-1908
US

IV. Provider business mailing address

1370 TURNERS RIDGE DR
NORCROSS GA
30093-2382
US

V. Phone/Fax

Practice location:
  • Phone: 770-457-4401
  • Fax:
Mailing address:
  • Phone: 678-900-7443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH33775
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: