Provider Demographics
NPI:1396839742
Name:BUI, KHANH T (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KHANH
Middle Name:T
Last Name:BUI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 ORCHARD HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078
Mailing Address - Country:US
Mailing Address - Phone:717-832-6218
Mailing Address - Fax:
Practice Address - Street 1:30 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078
Practice Address - Country:US
Practice Address - Phone:717-838-6355
Practice Address - Fax:717-832-0728
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044043L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist