Provider Demographics
NPI:1518563592
Name:NGUYEN, ANH QUOC (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANH
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 KENTUCKY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MINERAL
Mailing Address - State:VA
Mailing Address - Zip Code:23117
Mailing Address - Country:US
Mailing Address - Phone:540-894-0650
Mailing Address - Fax:540-896-0691
Practice Address - Street 1:11010 KENTUCKY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MINERAL
Practice Address - State:VA
Practice Address - Zip Code:23117
Practice Address - Country:US
Practice Address - Phone:540-894-0650
Practice Address - Fax:540-894-0691
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist