Provider Demographics
NPI:1497370290
Name:VU, CHI THUC (PHAMD)
Entity Type:Individual
Prefix:DR
First Name:CHI
Middle Name:THUC
Last Name:VU
Suffix:
Gender:F
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 SPOTTED WOLF AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-4873
Mailing Address - Country:US
Mailing Address - Phone:702-488-8199
Mailing Address - Fax:
Practice Address - Street 1:791 MARKS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8601
Practice Address - Country:US
Practice Address - Phone:702-352-2030
Practice Address - Fax:702-352-2021
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist