Healthcare Provider Details

I. General information

NPI: 1841607728
Provider Name (Legal Business Name): THANH-NGA NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2014
Last Update Date: 12/29/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1308
US

IV. Provider business mailing address

2419 ANGEL DR NW
ALBUQUERQUE NM
87120-1186
US

V. Phone/Fax

Practice location:
  • Phone: 505-881-5210
  • Fax: 505-872-2613
Mailing address:
  • Phone: 505-480-8295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008180
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: