Provider Demographics
NPI:1528577988
Name:NGO, THU TRONG (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:THU
Middle Name:TRONG
Last Name:NGO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 COMMUNITY COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1144
Mailing Address - Country:US
Mailing Address - Phone:702-486-0693
Mailing Address - Fax:702-486-7154
Practice Address - Street 1:2008 BLOOMFIELD CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6229
Practice Address - Country:US
Practice Address - Phone:714-317-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV144211835P1300X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric