Provider Demographics
NPI:1194026450
Name:NGUYEN, VINH VAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6235 OXON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3010
Mailing Address - Country:US
Mailing Address - Phone:301-839-0729
Mailing Address - Fax:301-567-7092
Practice Address - Street 1:6235 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3010
Practice Address - Country:US
Practice Address - Phone:301-839-0729
Practice Address - Fax:301-567-7092
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14658183500000X
TX44875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist