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NPI Code Detail

MEDICARE: LONG NGUYEN

MEDICARE: LONG NGUYEN
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
1183500000XPharmacistS014272AZ

General Provider Information

NPI Number : 1164844502
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONG NGUYEN
Provider Business Mailing Address
First Line : 7575 W LOWER BUCKEYE RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-3450
Country : US
Telephone Number : 623-907-0712
Fax Number : 623-907-0805
Provider Business Practice Location Address
First Line : 7575 W LOWER BUCKEYE RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-3450
Country : US
Telephone Number : 623-907-0712
Fax Number : 623-907-0805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2014
Last Update Date : 01/18/2014

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Directions to “ LONG NGUYEN ” Practice Location

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