Healthcare Provider Details

I. General information

NPI: 1619295326
Provider Name (Legal Business Name): STEVEN THANH NGUYEN PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W JOE HARVEY BLVD
HOBBS NM
88240
US

IV. Provider business mailing address

3901 N CENTRAL DR APT. G 107
HOBBS NM
88240-1143
US

V. Phone/Fax

Practice location:
  • Phone: 575-392-0053
  • Fax:
Mailing address:
  • Phone: 504-208-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007430
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: