Provider Demographics
NPI:1629446562
Name:NGUYEN, VINH XUAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VINH
Middle Name:XUAN
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 1:1353 PARK HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3887
Mailing Address - Country:US
Mailing Address - Phone:678-231-1213
Mailing Address - Fax:
Practice Address - Street 1:2473 HACKWORTH RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35214-1909
Practice Address - Country:US
Practice Address - Phone:205-798-9619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist