Healthcare Provider Details

I. General information

NPI: 1083904346
Provider Name (Legal Business Name): TAM THANH NGUYEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 E MARKET ST
HARRISONBURG VA
22801-5114
US

IV. Provider business mailing address

1790 E MARKET ST
HARRISONBURG VA
22801-5114
US

V. Phone/Fax

Practice location:
  • Phone: 540-432-1131
  • Fax:
Mailing address:
  • Phone: 540-432-1131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204131
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: