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General NPI Number Information
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NPI Number | 1548673361
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Entity Type | Individual
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Provider Name | LIEM NGUYEN RPH
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Gender | Male
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 8244 RICHMOND HWY
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City | ALEXANDRIA
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State | VA
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Zip | 22309-8220
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Country | US
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Telephone | 703-780-8020
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Fax | 703-780-6909
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Provider Business Mailing Address
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Address Line | 8376 BROUGHTON CRAGGS LN
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City | LORTON
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State | VA
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Zip | 22079-2773
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Country | US
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Telephone | 703-780-8020
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Fax | 703-780-6908
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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 | 0202012472
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License Number State | VA
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