Healthcare Provider Details

I. General information

NPI: 1891167755
Provider Name (Legal Business Name): THINK DIFFERENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2015
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31710 50TH LN SW APT V201
FEDERAL WAY WA
98023-3747
US

IV. Provider business mailing address

31710 50TH LN SW APT V201
FEDERAL WAY WA
98023-3747
US

V. Phone/Fax

Practice location:
  • Phone: 760-473-9269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS THINH TRUONG VU
Title or Position: FOUNDER
Credential: PHARMD
Phone: 760-473-9269