MEDICARE: MS. UYEN TRAN NGHI NGUYEN PHARMACIST

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	5302032379	MI

General Provider Information

NPI Number	:	1952421489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. UYEN TRAN NGHI NGUYEN PHARMACIST

Provider Business Mailing Address
First Line	:	6699 CRYSTAL DOWNES CT SE
Second Line	:
City	:	CALEDONIA
State	:	MI
Zip	:	49316-9085
Country	:	US
Telephone Number	:	616-532-9241
Fax Number	:	616-408-0158

Provider Business Practice Location Address
First Line	:	4410 DIVISION AVE S
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49548-4305
Country	:	US
Telephone Number	:	616-532-9241
Fax Number	:	616-408-0158

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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