Active NPI
Mary Nguyen
- Pharmacist
- Grants Pass, OR
National Provider Identifier
1669023404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0017482
- Practice address
- 1642 Williams Hwy
Grants Pass, OR 97527-5660 - Phone
- (541) 479-6698
- NPI assigned
- Sep 23, 2019
- 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 | RPH-0017482 | OR | Primary |
Addresses
Primary practice location
1642 Williams Hwy
Grants Pass, OR 97527-5660
Mailing address
2293 Bromley St Apt 4
Medford, OR 97501-7533
Phone (225) 718-8755
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 |
|---|---|---|---|
| RPH-0017482 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1669023404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2293 BROMLEY ST APT 4",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975017533",
"telephone_number": "225-718-8755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1642 WILLIAMS HWY",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275660",
"telephone_number": "541-479-6698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0017482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.