Individual
DR. SAMANTHA NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2017028143
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017028143
PHARMACY LICENSE
MO
Enumeration date
07/13/2018
Last updated
07/13/2018
Update your record
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