Provider Demographics
NPI:1477132512
Name:NGUYEN RAHEB, THU-TRANG (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:THU-TRANG
Middle Name:
Last Name:NGUYEN RAHEB
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CHAPMAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5400
Mailing Address - Country:US
Mailing Address - Phone:401-444-4909
Mailing Address - Fax:
Practice Address - Street 1:117 CHAPMAN ST STE 200
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-5400
Practice Address - Country:US
Practice Address - Phone:401-444-9909
Practice Address - Fax:401-444-4095
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH06195183500000X
MAPH239218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist