Provider Demographics
NPI:1083914170
Name:NGUYEN, TRIET (TONY) N (RPH)
Entity Type:Individual
Prefix:MR
First Name:TRIET (TONY)
Middle Name:N
Last Name:NGUYEN
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 1:7414 LITTLE RIVER TPKE
Mailing Address - Street 2:---- SAFEWAY PHARMACY -----
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3013
Mailing Address - Country:US
Mailing Address - Phone:703-269-1955
Mailing Address - Fax:703-269-1942
Practice Address - Street 1:7414 LITTLE RIVER TPKE
Practice Address - Street 2:---- SAFEWAY PHARMACY -----
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3013
Practice Address - Country:US
Practice Address - Phone:703-269-1955
Practice Address - Fax:703-269-1942
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist