Provider Demographics
NPI:1053681494
Name:VU, PHIPHUNG THI
Entity Type:Individual
Prefix:
First Name:PHIPHUNG
Middle Name:THI
Last Name:VU
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 1:8510 TINDAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-4939
Mailing Address - Country:US
Mailing Address - Phone:703-732-5366
Mailing Address - Fax:301-586-0873
Practice Address - Street 1:12000 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1985
Practice Address - Country:US
Practice Address - Phone:301-586-0873
Practice Address - Fax:301-586-0873
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist