Provider Demographics
NPI:1760757660
Name:VO, THONG VAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:THONG
Middle Name:VAN
Last Name:VO
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 1:492 KELKER ST
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17113-1907
Mailing Address - Country:US
Mailing Address - Phone:717-564-1524
Mailing Address - Fax:
Practice Address - Street 1:5125 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2990
Practice Address - Country:US
Practice Address - Phone:717-412-2052
Practice Address - Fax:717-412-2071
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040830L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist