Provider Demographics
NPI:1467855965
Name:NGUYEN, NGA HOANG (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:NGA
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4445
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-4445
Mailing Address - Country:US
Mailing Address - Phone:228-207-0960
Mailing Address - Fax:228-207-2787
Practice Address - Street 1:801 HIGHWAY 11 S
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-5382
Practice Address - Country:US
Practice Address - Phone:769-926-2730
Practice Address - Fax:769-926-2731
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-11790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist