Healthcare Provider Details

I. General information

NPI: 1912053844
Provider Name (Legal Business Name): THU ANH BUI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/24/2016
Certification Date:
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

PO BOX 1572
ANNANDALE VA
22003-9550
US

V. Phone/Fax

Practice location:
  • Phone: 703-237-2182
  • Fax: 703-237-0613
Mailing address:
  • Phone: 703-237-2182
  • Fax: 703-237-0613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number0202013055
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: