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General NPI Number Information
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NPI Number | 1942805759
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Entity Type | Individual
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Provider Name | HOANG MAI THI NGUYEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 485 CONCORD RD SE
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City | SMYRNA
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State | GA
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Zip | 30082-3226
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Country | US
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Telephone | 770-444-0182
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Fax | 770-437-0649
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Provider Business Mailing Address
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Address Line | 1225 GREENWICH ST SW
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City | ATLANTA
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State | GA
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Zip | 30310-1609
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Country | US
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Telephone | 404-723-3199
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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 | RPH026677
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License Number State | GA
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