MEDICARE: QUYEN DUC LE 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	14822	NV

General Provider Information

NPI Number	:	1205111531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUYEN DUC LE RPH

Provider Business Mailing Address
First Line	:	770 S HIGHWAY 160
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-4639
Country	:	US
Telephone Number	:	775-751-8399
Fax Number	:	775-751-8864

Provider Business Practice Location Address
First Line	:	770 S HIGHWAY 160
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-4639
Country	:	US
Telephone Number	:	775-751-8399
Fax Number	:	775-751-8864

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

Provider Enumeration Date	:	10/18/2011
Last Update Date	:	10/18/2011

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Directions to “ QUYEN DUC LE RPH” Practice Location

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