Tony Hieu Nguyen, PHARM D
Individual provider Active NPI Pharmacist · Pineville, MO
NPI 1124628698 · NPPES record last updated Oct 26, 2020
Key facts
- NPI
- 1124628698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2010025214 (MO)
- Practice address
- 100 Commercial LN
Pineville, MO 64856-7069 - Phone
- (417) 226-5811
- Fax
- (417) 226-5811
- NPI assigned
- Oct 26, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD11396 | AR | MD | Pharmacist |
| 2010025214 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD11396 | AR | |
| Pharmacist | 183500000X | 2010025214 | MO | Yes |
Addresses
Primary practice location
100 Commercial LN
Pineville, MO 64856-7069
Mailing address
4300 W Arlington Dr
Rogers, AR 72758-8927
Phone (501) 940-3393
Other providers in Pineville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.