Provider Demographics
NPI:1720622558
Name:PHAM, NHU EMILY (PHARMD)
Entity Type:Individual
Prefix:
First Name:NHU
Middle Name:EMILY
Last Name:PHAM
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 1:911 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-1211
Mailing Address - Country:US
Mailing Address - Phone:251-368-1451
Mailing Address - Fax:
Practice Address - Street 1:911 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-1211
Practice Address - Country:US
Practice Address - Phone:368-145-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59296183500000X
AL21152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist