Active NPI
Mary Nguyen
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1104736628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP042343Y
- Practice address
- 1500 E Erie Ave
Philadelphia, PA 19124-5642 - Phone
- (215) 289-9500
- Fax
- (215) 289-9503
- NPI assigned
- Sep 8, 2026
- Last updated
- Sep 8, 2026
- Sex
- Female
- Sole proprietor
- No
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 | RP042343Y | PA | Primary |
Addresses
Primary practice location
1500 E Erie Ave
Philadelphia, PA 19124-5642
Mailing address
1500 E Erie Ave
Philadelphia, PA 19124-5642
Phone (215) 289-9500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP042343Y | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmacy of America Inc | 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.
-
dba Pharmacy of America
- Community/Retail Pharmacy
- Philadelphia, PA
- NPI 1063655389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1104736628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E ERIE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191245642",
"telephone_number": "215-289-9500",
"fax_number": "215-289-9503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E ERIE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191245642",
"telephone_number": "215-289-9500",
"fax_number": "215-289-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP042343Y",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.