Provider Demographics
NPI:1265759385
Name:LUU, HOAN KIM (RPH)
Entity type:Individual
Prefix:
First Name:HOAN
Middle Name:KIM
Last Name:LUU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1219
Mailing Address - Country:US
Mailing Address - Phone:240-912-5743
Mailing Address - Fax:
Practice Address - Street 1:10134 RIVER RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4903
Practice Address - Country:US
Practice Address - Phone:301-299-8600
Practice Address - Fax:301-299-9523
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist