Provider Demographics
NPI:1003570102
Name:HOANG, HIEU THANH (RPH)
Entity Type:Individual
Prefix:
First Name:HIEU
Middle Name:THANH
Last Name:HOANG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18039 DUMFRIES SHOPPING PLZ
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2356
Mailing Address - Country:US
Mailing Address - Phone:703-221-4220
Mailing Address - Fax:
Practice Address - Street 1:18039 DUMFRIES SHOPPING PLZ
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2356
Practice Address - Country:US
Practice Address - Phone:703-221-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202219351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist