Organization
WALGREENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA THANH VAN NGUYEN PHARM.D. (PHARMACIST)
(703) 402-2568
Entity
Organization
Contact information
Practice address
3505 NUTLEY ST, SUITE A, FAIRFAX, VA 22031
(703) 280-8259
Mailing address
12151 BRIDGEND RUN, FAIRFAX, VA 22030-8901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0202213173
VA
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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