Healthcare Provider Details

I. General information

NPI: 1083173355
Provider Name (Legal Business Name): HOA NGUYEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 W LAKE MEAD BLVD
NORTH LAS VEGAS NV
89032-4895
US

IV. Provider business mailing address

3950 W LAKE MEAD BLVD
NORTH LAS VEGAS NV
89032-4895
US

V. Phone/Fax

Practice location:
  • Phone: 702-631-6806
  • Fax: 702-631-7965
Mailing address:
  • Phone: 702-631-6806
  • Fax: 702-631-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20146
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.22040
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: