Provider Demographics
NPI:1639497696
Name:NGUYEN, HIEP MINH (PHARM D)
Entity Type:Individual
Prefix:
First Name:HIEP
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 SAVONA QUAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7715
Mailing Address - Country:US
Mailing Address - Phone:310-756-4142
Mailing Address - Fax:
Practice Address - Street 1:2129 GENERAL BOOTH BLVD
Practice Address - Street 2:# 119
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5872
Practice Address - Country:US
Practice Address - Phone:757-427-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist