Provider Demographics
NPI:1659900249
Name:VAN, MINH CAOHIEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:CAOHIEN
Last Name:VAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 FLINTHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-4951
Mailing Address - Country:US
Mailing Address - Phone:404-545-0901
Mailing Address - Fax:
Practice Address - Street 1:5200 WINDWARD PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3842
Practice Address - Country:US
Practice Address - Phone:770-777-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist