Phuong Mai Hoang, PHARMD
Individual provider Active NPI Pharmacist · Bisbee, AZ
NPI 1689149684 · NPPES record last updated Jul 31, 2019
Key facts
- NPI
- 1689149684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S023769 (AZ)
- Practice address
- 101 Naco Rd
Bisbee, AZ 85603-9655 - Phone
- (703) 340-9101
- NPI assigned
- Oct 5, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| S023769 | AZ | MD | Pharmacist |
| RP452612 | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP452612 | PA | |
| Pharmacist | 183500000X | S023769 | AZ | Yes |
Addresses
Primary practice location
101 Naco Rd
Bisbee, AZ 85603-9655
Mailing address
101 Naco Rd
Bisbee, AZ 85603-9655
Phone (703) 340-9101
Other practice location 1
1640 Bethlehem Pike
Flourtown, PA 19031-2026
Phone (703) 340-9101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S023769 | Other | AZ | ARIZONA STATE BOARD OF PHARMACY |
| RP452612 | Other | PA | STATE BOARD OF PHARMACY |
Other providers in Bisbee, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2019. 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.