Provider Demographics
NPI:1275156572
Name:NGUYEN, HERBERT T (PHARMD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 HARFORD LN
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1510
Mailing Address - Country:US
Mailing Address - Phone:703-426-8357
Mailing Address - Fax:
Practice Address - Street 1:5100 HARFORD LN
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1510
Practice Address - Country:US
Practice Address - Phone:703-426-8357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022160863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy