Provider Demographics
NPI:1144698267
Name:NGUYEN LE, ANHDAO
Entity type:Individual
Prefix:
First Name:ANHDAO
Middle Name:
Last Name:NGUYEN LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 THOROUGHBRED LN
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8543
Mailing Address - Country:US
Mailing Address - Phone:205-540-3508
Mailing Address - Fax:
Practice Address - Street 1:335 HELENA MARKET PL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3386
Practice Address - Country:US
Practice Address - Phone:205-624-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-05
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist