Provider Demographics
NPI:1912207762
Name:DUONG, ANDY QUANGMINH (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:QUANGMINH
Last Name:DUONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11283 W ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-1960
Mailing Address - Country:US
Mailing Address - Phone:303-334-7127
Mailing Address - Fax:
Practice Address - Street 1:500 QUIVAS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4916
Practice Address - Country:US
Practice Address - Phone:303-602-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17585183500000X
TX37724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist