Healthcare Provider Details

I. General information

NPI: 1528463031
Provider Name (Legal Business Name): LINH VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 W MARKET ST
GREENSBORO NC
27407-1404
US

IV. Provider business mailing address

4808 W MARKET ST
GREENSBORO NC
27407-1404
US

V. Phone/Fax

Practice location:
  • Phone: 336-852-7018
  • Fax: 336-852-4927
Mailing address:
  • Phone: 336-852-7018
  • Fax: 336-852-4927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24676
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: