MEDICARE: HOANG HUY LE

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	6289483-1701	UT

General Provider Information

NPI Number	:	1518242023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOANG HUY LE

Provider Business Mailing Address
First Line	:	10319 LEGACY CV
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-4579
Country	:	US
Telephone Number	:	801-897-7143
Fax Number	:

Provider Business Practice Location Address
First Line	:	5630 W 4100 S
Second Line	:
City	:	WEST VALLEY
State	:	UT
Zip	:	84128-4338
Country	:	US
Telephone Number	:	801-840-5155
Fax Number	:

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

Provider Enumeration Date	:	10/15/2011
Last Update Date	:	10/15/2011

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