Provider Demographics
NPI:1881318715
Name:NGUYEN, LAM HOANGANH (PHARMD)
Entity type:Individual
Prefix:
First Name:LAM
Middle Name:HOANGANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1598 LUCIUS ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-3140
Mailing Address - Country:US
Mailing Address - Phone:228-243-7107
Mailing Address - Fax:
Practice Address - Street 1:917 DIVISION ST STE B
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3001
Practice Address - Country:US
Practice Address - Phone:228-280-8931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-100451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist