Active NPI
Brian Dinh Pham, RPH
- Pharmacist
- Norcross, GA
National Provider Identifier
1003190976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH022479
- Practice address
- 5296 Jimmy Carter Blvd
Norcross, GA 30093-1603 - Phone
- (770) 798-9355
- Fax
- (770) 798-9975
- NPI assigned
- Oct 10, 2011
- Last updated
- Oct 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH022479 | GA | Primary |
Addresses
Primary practice location
5296 Jimmy Carter Blvd
Norcross, GA 30093-1603
Mailing address
5296 Jimmy Carter Blvd
Norcross, GA 30093-1603
Phone (770) 798-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH022479 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1003190976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5296 JIMMY CARTER BLVD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300931603",
"telephone_number": "770-798-9355",
"fax_number": "770-798-9975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5296 JIMMY CARTER BLVD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300931603",
"telephone_number": "770-798-9355",
"fax_number": "770-798-9975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "BRIAN",
"middle_name": "DINH",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-10",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH022479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.