Provider Demographics
NPI:1649568585
Name:VU, TRUNG C (RPH)
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:C
Last Name:VU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11236 ROBINWOOD DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6704
Mailing Address - Country:US
Mailing Address - Phone:301-676-5876
Mailing Address - Fax:
Practice Address - Street 1:11236 ROBINWOOD DR
Practice Address - Street 2:SUITE 104
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6704
Practice Address - Country:US
Practice Address - Phone:301-676-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist