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NPI Code Detail

MEDICARE: LONG DINH PHARM.D.

MEDICARE: LONG DINH PHARM.D.
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
1183500000XPharmacist16315OK

General Provider Information

NPI Number : 1538537287
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONG DINH PHARM.D.
Provider Business Mailing Address
First Line : 7930 NW EXPRESSWAY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73132-1559
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7930 NW EXPRESSWAY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73132-1559
Country : US
Telephone Number : 405-773-5069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2015
Last Update Date : 09/11/2015

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