Healthcare Provider Details

I. General information

NPI: 1689591984
Provider Name (Legal Business Name): JULIE LAM THANH NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5119 WASHINGTON RD
EVANS GA
30809-6445
US

IV. Provider business mailing address

2525 CENTER WEST PKWY APT 9D
AUGUSTA GA
30909-4683
US

V. Phone/Fax

Practice location:
  • Phone: 706-650-1460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036284
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: