Provider Demographics
NPI:1952744112
Name:NGUYEN, LAM THANH (RPH)
Entity Type:Individual
Prefix:MR
First Name:LAM
Middle Name:THANH
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 1:2727 W EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5507
Mailing Address - Country:US
Mailing Address - Phone:303-936-2377
Mailing Address - Fax:303-937-4427
Practice Address - Street 1:2727 W EVANS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-5507
Practice Address - Country:US
Practice Address - Phone:303-936-2377
Practice Address - Fax:303-937-4427
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist