Individual
HIEU PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4142 PONTCHARTRAIN DR, SLIDELL, LA 70458-5138
(985) 649-3490
Mailing address
325 WINDWARD PASSAGE ST, SLIDELL, LA 70458-9019
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
045661
LA
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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