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General NPI Number Information
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NPI Number | 1255494589
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Entity Type | Organization
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Legal Business Name | TU QUYNH PHARMACY, INC.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 230 GRAND ST # A1-2
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City | NEW YORK
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State | NY
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Zip | 10013-4241
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Country | US
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Telephone | 212-219-8998
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Fax | 212-219-3822
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Provider Business Mailing Address
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Address Line | 230 GRAND ST # A1-2
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City | NEW YORK
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State | NY
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Zip | 10013-4241
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Country | US
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Telephone | 212-219-8998
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Fax | 212-219-3822
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THAO KIM DOAN
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Credential | PHARM.D.
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Telephone | 212-219-8998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 049472
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License Number State | NY
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