Provider Demographics
NPI:1912501396
Name:VO, MINHTHU
Entity Type:Individual
Prefix:
First Name:MINHTHU
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SAGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-7426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1802
Practice Address - Country:US
Practice Address - Phone:508-358-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist