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NPI Code Detail

MEDICARE: DR. NGUYET THU THI NGUYEN RPH

MEDICARE: DR. NGUYET THU THI 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
1183500000XPharmacist0202217056VA

General Provider Information

NPI Number : 1295330272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NGUYET THU THI NGUYEN RPH
Provider Business Mailing Address
First Line : 10901 W BROAD ST
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-5935
Country : US
Telephone Number : 804-935-6916
Fax Number :
Provider Business Practice Location Address
First Line : 10901 W BROAD ST
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-5935
Country : US
Telephone Number : 804-935-6916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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