Provider Demographics
NPI:1083796866
Name:NGUYEN-VU CO
Entity Type:Organization
Organization Name:NGUYEN-VU CO
Other - Org Name:LA ROSA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LOI
Authorized Official - Middle Name:T
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-481-6602
Mailing Address - Street 1:11002 SCARSDALE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11002 SCARSDALE BLVD
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6000
Practice Address - Country:US
Practice Address - Phone:281-481-6602
Practice Address - Fax:281-464-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX18276333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144628Medicaid
4501816OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4501816OtherOTHER ID NUMBER-COMMERCIAL NUMBER