Provider Demographics
NPI:1760086375
Name:NGUYEN, TAMMY HOANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:HOANG
Last Name:NGUYEN
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 1:43269 VALIANT DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3426
Mailing Address - Country:US
Mailing Address - Phone:703-542-2598
Mailing Address - Fax:
Practice Address - Street 1:7501 HUNTSMAN BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-1649
Practice Address - Country:US
Practice Address - Phone:703-866-2336
Practice Address - Fax:703-866-1993
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist