| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MAI THANH NGUYEN | 1871197749 | 2020-11-22 |
Mai Thanh Nguyen is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1871197749. Registration indicates Mai Thanh Nguyen is a provider of services with a specialization in Pharmacy Service Providers, Pharmacist (Pharmacist, ) (Pharmacist, Pharmacy Service Providers)
| Entity Type | Individual |
| Provider Name | Mai Thanh Nguyen PHARM D. |
| Practice Office Address | 11003 LEE HWY FAIRFAX, VA US |
| Practice Office Telephone | 5714325801 |
| Practice Office Fax | 5714325807 |
| Mailing Address | 4711 LOGWOOD LN CHANTILLY, VA 201512459 US |
| Business Telephone | 7032170674 |
| Code | Practice | License No State |
|---|---|---|
| 183500000X PRIMARY | Pharmacy Service Providers Pharmacist Pharmacist Pharmacist Pharmacy Service Providers | 0202204856
VA |
| 193200000X MULT | Group Code |