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General NPI Number Information
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NPI Number | 1497139463
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Entity Type | Individual
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Provider Name | THAI HUYNH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2015
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 3138 ROGERS AVE
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-3320
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Country | US
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Telephone | 443-200-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4389 HAMBRICK WAY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-1717
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Country | US
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Telephone | 404-514-2016
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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 | RPH028553
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License Number State | GA
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