Saigon Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAIGON PHARMACY LLC

Doing business as

Saigon Pharmacare

Practice address

1165 Main St
Forest Park, GA 30297-1443

Phone

(770) 888-2235

Fax

(770) 888-2235

NPI assigned

May 14, 2020

Last updated

Mar 29, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lam Le, PHARMD

Title

Owner

Phone

(770) 888-2235

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Saigon Pharmacare Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Tax ID family

Saigon Pharmacare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Saigon Pharmacy LLC

  dba Saigon Pharmacare

  • Long Term Care Pharmacy
  • Forest Park, GA
  • NPI 1013731769
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vinh Mai, RPH

  • Pharmacy
  • Forest Park, GA
  • NPI 1033734140
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1073135893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MAIN ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971443",
            "telephone_number": "770-888-2235",
            "fax_number": "770-888-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MAIN ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971443",
            "telephone_number": "770-888-2235",
            "fax_number": "770-888-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAIGON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "LAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-888-2235",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003234388A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saigon Pharmacare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saigon Pharmacare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arleen Revely, NP
• Andrea Nicholle Robinson
• Lisa Roseberry, NP
• Sherica Nicole Rosser, MD
• Saigon Pharmacy LLC (Saigon Pharmacare)
• San Jose Supplies
• Seacoast at Governor's Glen
• Secured Care Home Health Services Inc.
• Self Love Solutions
• David James Shaver

• Community/Retail Pharmacy in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.