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General NPI Number Information
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NPI Number | 1508417411
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Entity Type | Individual
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Provider Name | TRUONG LUU
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Gender | Female
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 5805 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-1125
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Country | US
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Telephone | 215-821-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 SCHOOL LN
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City | DREXEL HILL
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State | PA
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Zip | 19026-3113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | RP040652L
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License Number State | PA
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