Provider Demographics
NPI:1326348913
Name:NGUYEN, CHUONG HOANG
Entity Type:Individual
Prefix:
First Name:CHUONG
Middle Name:HOANG
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 1:550 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:ST DAVIDS
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5044
Mailing Address - Country:US
Mailing Address - Phone:610-263-2015
Mailing Address - Fax:
Practice Address - Street 1:550 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:ST DAVIDS
Practice Address - State:PA
Practice Address - Zip Code:19087-5044
Practice Address - Country:US
Practice Address - Phone:610-263-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist