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NPI Code Detail

MEDICARE: MYLIEN T TRUONG

MEDICARE: MYLIEN T TRUONG
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
1183500000XPharmacist16940NC

General Provider Information

NPI Number : 1720399959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYLIEN T TRUONG
Provider Business Mailing Address
First Line : 5740 N GRAHAM ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-4839
Country : US
Telephone Number : 704-596-1034
Fax Number : 704-599-2940
Provider Business Practice Location Address
First Line : 5740 N GRAHAM ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-4839
Country : US
Telephone Number : 704-596-1034
Fax Number : 704-599-2940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2010
Last Update Date : 06/22/2010

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Directions to “ MYLIEN T TRUONG ” Practice Location

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