Provider Demographics
NPI:1235766130
Name:NGUYEN, TRI HUU
Entity Type:Individual
Prefix:
First Name:TRI
Middle Name:HUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 CHAPEL LN
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-7518
Mailing Address - Country:US
Mailing Address - Phone:513-206-0975
Mailing Address - Fax:
Practice Address - Street 1:10477 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-1941
Practice Address - Country:US
Practice Address - Phone:513-367-2382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020033183500000X
OH03337178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist