MEDICARE: TERESA NGOC NGUYEN RPH

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	PS57452	FL

General Provider Information

NPI Number	:	1942702865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA NGOC NGUYEN RPH

Provider Business Mailing Address
First Line	:	6061 64TH AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-5324
Country	:	US
Telephone Number	:	951-375-8583
Fax Number	:

Provider Business Practice Location Address
First Line	:	6061 64TH AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-5324
Country	:	US
Telephone Number	:	951-375-8583
Fax Number	:

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

Provider Enumeration Date	:	03/07/2018
Last Update Date	:	03/07/2018

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