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General NPI Number Information
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NPI Number | 1730487216
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Entity Type | Individual
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Provider Name | MRS. HANH PHAM
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Gender | Female
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 2900 WATSON BLVD
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City | CENTERVILLE
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State | GA
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Zip | 31028-1771
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Country | US
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Telephone | 478-953-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 98 GLEN ARBOR LN
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City | WARNER ROBINS
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State | GA
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Zip | 31088-9172
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Country | US
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Telephone | 318-617-4928
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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 | RPH025734
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License Number State | GA
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