Provider Demographics
NPI:1285245910
Name:VO, QUYNH-ANH
Entity type:Individual
Prefix:
First Name:QUYNH-ANH
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5296 JIMMY CARTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1603
Mailing Address - Country:US
Mailing Address - Phone:770-798-9355
Mailing Address - Fax:770-798-9975
Practice Address - Street 1:5296 JIMMY CARTER BLVD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1603
Practice Address - Country:US
Practice Address - Phone:770-798-9355
Practice Address - Fax:770-798-9975
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239035183500000X
GARPH032783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist