Provider Demographics
NPI:1255116596
Name:TONNGUYEN, ANHTHU (PHARMD)
Entity type:Individual
Prefix:
First Name:ANHTHU
Middle Name:
Last Name:TONNGUYEN
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 1:10210 BUSHMAN DR APT 303
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-2816
Mailing Address - Country:US
Mailing Address - Phone:703-405-8546
Mailing Address - Fax:
Practice Address - Street 1:8117 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2712
Practice Address - Country:US
Practice Address - Phone:703-761-3924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist