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NPI Code Detail

MEDICARE: THANHTHUY THI HOANG PHARM. D

MEDICARE:   THANHTHUY THI HOANG  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
1183500000XPharmacistRPH020744GA

General Provider Information

NPI Number : 1790151603
Entity Type Code : Individual
Provider Name (Legal Business Name) : THANHTHUY THI HOANG PHARM. D
Provider Business Mailing Address
First Line : 895 HOLCOMB BRIDGE RD
Second Line :
City : ROSWELL
State : GA
Zip : 30076-1954
Country : US
Telephone Number : 770-993-0194
Fax Number :
Provider Business Practice Location Address
First Line : 895 HOLCOMB BRIDGE RD
Second Line :
City : ROSWELL
State : GA
Zip : 30076-1954
Country : US
Telephone Number : 770-993-0194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2015
Last Update Date : 08/14/2015

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