Provider Demographics
NPI:1700500675
Name:VU, KHOI MINH (RPH)
Entity Type:Individual
Prefix:
First Name:KHOI
Middle Name:MINH
Last Name:VU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8449 GRANITE SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7167
Mailing Address - Country:US
Mailing Address - Phone:714-470-0361
Mailing Address - Fax:
Practice Address - Street 1:60 N VALLE VERDE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1756
Practice Address - Country:US
Practice Address - Phone:702-898-0036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80239183500000X
NV19961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist