Provider Demographics
NPI:1992138903
Name:NGUYEN, VANCAC THI (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:VANCAC
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1200
Mailing Address - Country:US
Mailing Address - Phone:610-237-5097
Mailing Address - Fax:610-237-4389
Practice Address - Street 1:1500 LANSDOWNE AVE
Practice Address - Street 2:PHARMACY DEPARTMENT 4 CENTER
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1200
Practice Address - Country:US
Practice Address - Phone:610-237-5097
Practice Address - Fax:610-237-4389
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4446921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist