Healthcare Provider Details

I. General information

NPI: 1952205619
Provider Name (Legal Business Name): AN NGOC VO PHARMD, BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S COLLINS ST
TULLAHOMA TN
37388-3314
US

IV. Provider business mailing address

114 S COLLINS ST
TULLAHOMA TN
37388-3314
US

V. Phone/Fax

Practice location:
  • Phone: 931-841-7009
  • Fax:
Mailing address:
  • Phone: 931-841-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number43314
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: