Healthcare Provider Details

I. General information

NPI: 1447881594
Provider Name (Legal Business Name): AN HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N MAY AVE
OKLAHOMA CITY OK
73107-2011
US

IV. Provider business mailing address

8700 NW 114TH ST
OKLAHOMA CITY OK
73162-2223
US

V. Phone/Fax

Practice location:
  • Phone: 406-943-9361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18665
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: