Healthcare Provider Details

I. General information

NPI: 1760312557
Provider Name (Legal Business Name): VICTOR VINH HA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 W CENTER ST
PROVO UT
84601-4276
US

IV. Provider business mailing address

1850 W 2100 S
SALT LAKE CITY UT
84119-1304
US

V. Phone/Fax

Practice location:
  • Phone: 801-374-1704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14230312-1701
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4181008
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: