Provider Demographics
NPI:1770918922
Name:NGUYEN, ANH KIET T (PHARMD)
Entity type:Individual
Prefix:
First Name:ANH KIET
Middle Name:T
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 1:10270 COMMONWEALTH ST APT 5338
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5616
Mailing Address - Country:US
Mailing Address - Phone:303-523-6090
Mailing Address - Fax:
Practice Address - Street 1:10001 COMMONS ST
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5547
Practice Address - Country:US
Practice Address - Phone:303-209-1852
Practice Address - Fax:303-928-7050
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0020081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist