Provider Demographics
NPI:1811380264
Name:NGUYEN, DUY ANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:DUY
Middle Name:ANH
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 1:69630 STIRLING BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4620
Mailing Address - Country:US
Mailing Address - Phone:985-327-6261
Mailing Address - Fax:985-327-6255
Practice Address - Street 1:69630 STIRLING BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4620
Practice Address - Country:US
Practice Address - Phone:985-327-6261
Practice Address - Fax:985-327-6255
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.018855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist