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General NPI Number Information
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NPI Number | 1548817109
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Entity Type | Individual
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Provider Name | THANH VU MINH PHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 2131 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-1105
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Country | US
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Telephone | 215-236-2297
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Fax | 215-236-7216
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Provider Business Mailing Address
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Address Line | 6255 N 4TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120-1403
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Country | US
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Telephone | 267-437-9621
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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 | RP453802
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License Number State | PA
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