MEDICARE: THINH VAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	15536	CO

General Provider Information

NPI Number	:	1235572470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THINH VAN

Provider Business Mailing Address
First Line	:	5125 W FLORIDA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-3605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5125 W FLORIDA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-3605
Country	:	US
Telephone Number	:	303-936-7403
Fax Number	:	303-937-4426

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	04/08/2013

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Directions to “ THINH VAN ” Practice Location

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