MEDICARE: PHUONG H DINH

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	17307	NV

General Provider Information

NPI Number	:	1568745883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHUONG H DINH

Provider Business Mailing Address
First Line	:	6820 W ANN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6820 W ANN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1113
Country	:	US
Telephone Number	:	702-645-4106
Fax Number	:	702-645-2595

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

Provider Enumeration Date	:	09/22/2011
Last Update Date	:	09/22/2011

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Directions to “ PHUONG H DINH ” Practice Location

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