Healthcare Provider Details

I. General information

NPI: 1447618988
Provider Name (Legal Business Name): LINH HOANG NGUYEN RPH,PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 E PASS RD
GULFPORT MS
39507-3529
US

IV. Provider business mailing address

1733 E PASS RD
GULFPORT MS
39507-3529
US

V. Phone/Fax

Practice location:
  • Phone: 228-284-6990
  • Fax: 228-284-6989
Mailing address:
  • Phone: 228-284-6990
  • Fax: 228-284-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-14012
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: