MEDICARE: TIEN MINH NGUYEN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	15664	NV

General Provider Information

NPI Number	:	1043679707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIEN MINH NGUYEN RPH

Provider Business Mailing Address
First Line	:	7692 W MESA VERDE LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3057
Country	:	US
Telephone Number	:	714-420-8305
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 W CRAIG RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2558
Country	:	US
Telephone Number	:	702-395-1240
Fax Number	:	702-395-5370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2016
Last Update Date	:	02/22/2016

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Directions to “ TIEN MINH NGUYEN RPH” Practice Location

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