MEDICARE: MINH THU THUY NGUYEN PHARMD.

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	17886	CO

General Provider Information

NPI Number	:	1417298274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH THU THUY NGUYEN PHARMD.

Provider Business Mailing Address
First Line	:	5784 CLARET ST
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-2522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4503 JOHN F KENNEDY PARKWAY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2522
Country	:	US
Telephone Number	:	970-223-5769
Fax Number	:

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

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	03/04/2013

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