Healthcare Provider Details

I. General information

NPI: 1780215558
Provider Name (Legal Business Name): HUYEN THI VAN PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 N LAPEER RD
LAKE ORION MI
48362-1581
US

IV. Provider business mailing address

460 N LAPEER RD
LAKE ORION MI
48362-1581
US

V. Phone/Fax

Practice location:
  • Phone: 248-693-3284
  • Fax: 248-693-3507
Mailing address:
  • Phone: 248-693-3284
  • Fax: 248-693-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302411865
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: