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General NPI Number Information
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NPI Number | 1801489729
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Entity Type | Individual
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Provider Name | THUY THI ANTOLIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/12/2021
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 3699 HWAY 95
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-9118
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Country | US
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Telephone | 928-704-5064
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Fax |
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Provider Business Mailing Address
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Address Line | 6456 WRIGLEY CT
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City | LAS VEGAS
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State | NV
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Zip | 89141-7324
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Country | US
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Telephone | 702-883-2155
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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 | 20742
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License Number State | NV
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