Healthcare Provider Details
I. General information
NPI: 1457504177
Provider Name (Legal Business Name): THANH-HUONG NGUYEN PHARMD, RPH, PHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/25/2008
Last Update Date: 10/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1909 SEA FOAM ST NW
ALBUQUERQUE NM
87120-6245
US
IV. Provider business mailing address
1909 SEA FOAM ST NW
ALBUQUERQUE NM
87120-6245
US
V. Phone/Fax
- Phone: 505-404-0978
- Fax:
- Phone: 505-404-0978
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | PC157 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: