Healthcare Provider Details

I. General information

NPI: 1891001749
Provider Name (Legal Business Name): ANH NGUYEN PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2010
Last Update Date: 08/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10009 QUINTESSENCE RD NE
ALBUQUERQUE NM
87122-3345
US

IV. Provider business mailing address

10009 QUINTESSENCE RD NE
ALBUQUERQUE NM
87122-3345
US

V. Phone/Fax

Practice location:
  • Phone: 505-550-6710
  • Fax:
Mailing address:
  • Phone: 505-550-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007505
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: