Healthcare Provider Details

I. General information

NPI: 1326558099
Provider Name (Legal Business Name): TOAN HOANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3414 MUNDY MILL RD
GAINESVILLE GA
30507-8215
US

IV. Provider business mailing address

3414 MUNDY MILL RD
GAINESVILLE GA
30507-8215
US

V. Phone/Fax

Practice location:
  • Phone: 770-287-8359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH030256
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: