Provider Demographics
NPI:1700498482
Name:HA, THUY (PHARMD)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:
Last Name:HA
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 1:5906 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-1820
Mailing Address - Country:US
Mailing Address - Phone:913-333-2173
Mailing Address - Fax:
Practice Address - Street 1:4016 W 95TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2702
Practice Address - Country:US
Practice Address - Phone:913-307-3057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy