Healthcare Provider Details

I. General information

NPI: 1215754304
Provider Name (Legal Business Name): TU VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/22/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10380 E BROADWAY BLVD
TUCSON AZ
85748-3410
US

IV. Provider business mailing address

9046 N SAFFLOWER LN
TUCSON AZ
85743-8941
US

V. Phone/Fax

Practice location:
  • Phone: 520-918-7221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS027244
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: