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General NPI Number Information
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NPI Number | 1750986857
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Entity Type | Individual
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Provider Name | GIANG THI NGO
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Gender | Female
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 4325 BRETON RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49512-3820
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Country | US
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Telephone | 616-281-5442
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Fax | 616-281-6931
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Provider Business Mailing Address
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Address Line | 4325 BRETON RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49512-3820
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Country | US
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Telephone | 616-281-5442
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Fax | 616-281-6931
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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 | 302029648
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License Number State | MI
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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 | 5302029648
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License Number State | MI
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