Provider Demographics
NPI:1497417323
Name:NGUYEN, JEREMY TRUNG-HAU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:TRUNG-HAU
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 1:2230 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4231
Mailing Address - Country:US
Mailing Address - Phone:985-781-7541
Mailing Address - Fax:
Practice Address - Street 1:2230 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4231
Practice Address - Country:US
Practice Address - Phone:985-781-7541
Practice Address - Fax:985-781-7546
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist