Provider Demographics
NPI:1275179392
Name:NGUYEN, TRINH (RPH)
Entity Type:Individual
Prefix:
First Name:TRINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-6069
Mailing Address - Country:US
Mailing Address - Phone:734-482-9342
Mailing Address - Fax:734-483-8649
Practice Address - Street 1:1771 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-6069
Practice Address - Country:US
Practice Address - Phone:734-482-9342
Practice Address - Fax:734-483-8649
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-24
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty