Provider Demographics
NPI:1699096628
Name:VO, NGUYEN-NGOC THI (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:NGUYEN-NGOC
Middle Name:THI
Last Name:VO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MRS
Other - First Name:NGUYEN-NGOC
Other - Middle Name:THI
Other - Last Name:VO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:12007 GRENSHAW DR
Mailing Address - Street 2:12007 GRENSHAW DRIVE
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6183
Mailing Address - Country:US
Mailing Address - Phone:703-789-6306
Mailing Address - Fax:571-248-6855
Practice Address - Street 1:14610 LEE HWY
Practice Address - Street 2:14610 LEE HWY
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-1831
Practice Address - Country:US
Practice Address - Phone:571-248-6536
Practice Address - Fax:571-248-6855
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist