Active NPI
Van Thanh DO
- Pharmacist
- Stone Mountain, GA
National Provider Identifier
1235412347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH022939
- Practice address
- 5435 Five Forks Trickum Rd
Stone Mountain, GA 30087-3045 - Phone
- (770) 935-5607
- NPI assigned
- Sep 25, 2011
- 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 | RPH022939 | GA | Primary |
Addresses
Primary practice location
5435 Five Forks Trickum Rd
Stone Mountain, GA 30087-3045
Mailing address
1825 Severbrook PL
Lawrenceville, GA 30043-5194
Phone (678) 485-4089
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 |
|---|---|---|---|
| RPH022939 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316908800000",
"number": "1235412347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 SEVERBROOK PL",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435194",
"telephone_number": "678-485-4089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5435 FIVE FORKS TRICKUM RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300873045",
"telephone_number": "770-935-5607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "VAN",
"middle_name": "THANH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-25",
"last_updated": "2011-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH022939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.