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NPI Code Detail

MEDICARE: PHUONG THANH LUU PHARMD

MEDICARE:   PHUONG THANH LUU  PHARMD
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
1183500000XPharmacist019548KY
2183500000XPharmacist03237073OH

General Provider Information

NPI Number : 1760900278
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHUONG THANH LUU PHARMD
Provider Business Mailing Address
First Line : 9920 LANCEWOOD RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40229-1680
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 230 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-1263
Country : US
Telephone Number : 937-487-5042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2017
Last Update Date : 09/05/2017

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Directions to “ PHUONG THANH LUU PHARMD” Practice Location

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