Provider Demographics
NPI:1942759188
Name:VU, NGOC ANH CINDY CAO
Entity Type:Individual
Prefix:
First Name:NGOC ANH CINDY
Middle Name:CAO
Last Name:VU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:CAO
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RAH
Mailing Address - Street 1:10431 OLD HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4118
Mailing Address - Country:US
Mailing Address - Phone:504-432-1308
Mailing Address - Fax:
Practice Address - Street 1:10431 OLD HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4118
Practice Address - Country:US
Practice Address - Phone:504-432-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-14533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist