Provider Demographics
NPI:1942813845
Name:HA, NAM-THI TIFFANY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NAM-THI
Middle Name:TIFFANY
Last Name:HA
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 1:1200 GREENBRIER PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2899
Mailing Address - Country:US
Mailing Address - Phone:757-548-0165
Mailing Address - Fax:
Practice Address - Street 1:1200 GREENBRIER PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2899
Practice Address - Country:US
Practice Address - Phone:757-548-0165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist