Provider Demographics
NPI:1790409167
Name:BUI, TRUONG KHAC (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRUONG
Middle Name:KHAC
Last Name:BUI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 OREGON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4608
Mailing Address - Country:US
Mailing Address - Phone:717-560-1499
Mailing Address - Fax:717-569-5778
Practice Address - Street 1:2363 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4608
Practice Address - Country:US
Practice Address - Phone:717-560-1499
Practice Address - Fax:717-569-5778
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist