Healthcare Provider Details

I. General information

NPI: 1023865094
Provider Name (Legal Business Name): PHIANH LE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E VICTORY DR
SAVANNAH GA
31404-3713
US

IV. Provider business mailing address

1900 E VICTORY DR
SAVANNAH GA
31404-3713
US

V. Phone/Fax

Practice location:
  • Phone: 912-236-0750
  • Fax:
Mailing address:
  • Phone: 912-663-1668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH034848
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: