Provider Demographics
NPI:1922519891
Name:VU, TUAN HOANG
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:HOANG
Last Name:VU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S WISCONSIN AVE APT B
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3200
Mailing Address - Country:US
Mailing Address - Phone:714-420-8091
Mailing Address - Fax:
Practice Address - Street 1:400 S BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4005
Practice Address - Country:US
Practice Address - Phone:785-825-2248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017013502183500000X
KS1-100254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist