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General NPI Number Information
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NPI Number | 1629495197
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Entity Type | Individual
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Provider Name | TAM THANH HAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2014
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 1217 W JEFFERSON ST
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City | QUINCY
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State | FL
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Zip | 32351-2125
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Country | US
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Telephone | 850-627-7663
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Fax | 850-627-7673
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Provider Business Mailing Address
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Address Line | 1217 W JEFFERSON ST
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City | QUINCY
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State | FL
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Zip | 32351-2125
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Country | US
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Telephone | 850-627-7663
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Fax | 850-627-7673
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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 | RPH027094
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS50005
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License Number State | FL
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