Healthcare Provider Details

I. General information

NPI: 1942460944
Provider Name (Legal Business Name): MISS NHIEN HUONG BUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N PERIMETER RD
MALMSTROM AFB MT
59402-6701
US

IV. Provider business mailing address

33 BUTTONWOOD ST #3
DORCHESTER MA
02125-1205
US

V. Phone/Fax

Practice location:
  • Phone: 857-445-7304
  • Fax:
Mailing address:
  • Phone: 857-445-7304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7464
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: