Healthcare Provider Details

I. General information

NPI: 1336924372
Provider Name (Legal Business Name): VAN HONG BUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6795 WILSON BLVD STE 1A
FALLS CHURCH VA
22044-3313
US

IV. Provider business mailing address

6795 WILSON BLVD STE 1A
FALLS CHURCH VA
22044-3313
US

V. Phone/Fax

Practice location:
  • Phone: 703-237-2182
  • Fax:
Mailing address:
  • Phone: 240-418-4731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204710
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: