Provider Demographics
NPI:1801482021
Name:NGUYEN, HIEU K (RPH)
Entity type:Individual
Prefix:
First Name:HIEU
Middle Name:K
Last Name:NGUYEN
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 1:426 FARNSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-4140
Mailing Address - Country:US
Mailing Address - Phone:267-265-7778
Mailing Address - Fax:
Practice Address - Street 1:1115 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5065
Practice Address - Country:US
Practice Address - Phone:610-696-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437170183500000X
DEA1-0004407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist