Provider Demographics
NPI:1598863235
Name:PHUNG, CHRIS H (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:H
Last Name:PHUNG
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 1:604 KEENELAND CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-4662
Mailing Address - Country:US
Mailing Address - Phone:334-396-7990
Mailing Address - Fax:334-272-0882
Practice Address - Street 1:35 MITCHELL DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-2923
Practice Address - Country:US
Practice Address - Phone:334-272-0802
Practice Address - Fax:334-272-0882
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist