Provider Demographics
NPI:1376568329
Name:BUI, BICH THU
Entity Type:Individual
Prefix:
First Name:BICH
Middle Name:THU
Last Name:BUI
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:DIVINE HEALTH PRODUCTS
Mailing Address - Street 2:6130 ELTON AVENUE
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1189
Mailing Address - Country:US
Mailing Address - Phone:702-216-0332
Mailing Address - Fax:702-216-0333
Practice Address - Street 1:DIVINE HEALTH PRODUCTS
Practice Address - Street 2:6130 ELTON AVENUE
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1189
Practice Address - Country:US
Practice Address - Phone:702-216-0332
Practice Address - Fax:702-216-0333
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide