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General NPI Number Information
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NPI Number | 1154140101
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Entity Type | Individual
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Provider Name | MILEY PHUONG NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 919 W RIO ALTAR
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4036
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Country | US
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Telephone | 818-398-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 68 LHEUREUX CIR
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City | RANDOLPH
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State | MA
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Zip | 02368-5175
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Country | US
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Telephone | 857-763-9690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH1000368
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License Number State | MA
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