MEDICARE: PHUONG LHP 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
1	183500000X	Pharmacist	2010029516	MO

General Provider Information

NPI Number	:	1285110221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHUONG LHP NGUYEN

Provider Business Mailing Address
First Line	:	2 WILTON CT
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-4073
Country	:	US
Telephone Number	:	314-583-7419
Fax Number	:

Provider Business Practice Location Address
First Line	:	8037 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-1400
Country	:	US
Telephone Number	:	314-679-2402
Fax Number	:	314-679-2403

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

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	07/12/2018

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Directions to “ PHUONG LHP NGUYEN ” Practice Location

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