Healthcare Provider Details

I. General information

NPI: 1831632199
Provider Name (Legal Business Name): QUANG NGUYEN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 BOULEVARD
COLONIAL HEIGHTS VA
23834-1456
US

IV. Provider business mailing address

1906 QUIET OAKS CIR
HENRICO VA
23228-1554
US

V. Phone/Fax

Practice location:
  • Phone: 804-520-9641
  • Fax: 804-520-4296
Mailing address:
  • Phone: 804-503-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202215457
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: