Provider Demographics
NPI:1124607684
Name:PHAM, SOPHIA NGOC THUY (RPH)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:NGOC THUY
Last Name:PHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WOODVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8440
Mailing Address - Country:US
Mailing Address - Phone:603-264-9502
Mailing Address - Fax:
Practice Address - Street 1:3 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2528
Practice Address - Country:US
Practice Address - Phone:603-621-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist