Provider Demographics
NPI:1093474082
Name:DUONG, LOI (PHARMD)
Entity Type:Individual
Prefix:
First Name:LOI
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATTN: PHARMACY
Mailing Address - Street 2:1003 WILLOW CREEK RD
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1668
Mailing Address - Country:US
Mailing Address - Phone:928-771-5155
Mailing Address - Fax:928-771-5502
Practice Address - Street 1:ATTN: PHARMACY
Practice Address - Street 2:1003 WILLOW CREEK RD
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1668
Practice Address - Country:US
Practice Address - Phone:928-771-5155
Practice Address - Fax:928-771-5502
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist