Healthcare Provider Details

I. General information

NPI: 1770147209
Provider Name (Legal Business Name): AMY HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BRADLEY BLVD
BETHESDA MD
20815-6559
US

IV. Provider business mailing address

5000 BRADLEY BLVD
BETHESDA MD
20815-6559
US

V. Phone/Fax

Practice location:
  • Phone: 301-654-4169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24898
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: