Provider Demographics
NPI:1588271456
Name:NGUYEN, VINCENT JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:JOSEPH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 PLEASANT HILL RD STE 2
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1428
Mailing Address - Country:US
Mailing Address - Phone:770-225-5077
Mailing Address - Fax:855-844-4616
Practice Address - Street 1:3800 PLEASANT HILL RD STE 2
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1428
Practice Address - Country:US
Practice Address - Phone:770-225-5077
Practice Address - Fax:855-844-4616
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty