Provider Demographics
NPI:1811213226
Name:NGUYEN, VI THUY LE (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:VI
Middle Name:THUY LE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, MBA
Mailing Address - Street 1:6644 E BAYWOOD AVE
Mailing Address - Street 2:OUTPATIENT-MEDICATION MANAGEMENT CLINIC
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1747
Mailing Address - Country:US
Mailing Address - Phone:480-321-4396
Mailing Address - Fax:480-321-4588
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1747
Practice Address - Country:US
Practice Address - Phone:480-321-4396
Practice Address - Fax:480-321-4588
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0165691835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy