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General NPI Number Information
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NPI Number | 1700483906
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Entity Type | Individual
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Provider Name | KHOA VU
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Gender | Male
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 1601 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-3109
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Country | US
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Telephone | 856-757-3537
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Fax |
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Provider Business Mailing Address
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Address Line | 6016 JEFFERSON AVE
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City | PENNSAUKEN
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State | NJ
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Zip | 08110-1719
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Country | US
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Telephone | 856-278-2967
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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 | 28RI04057900
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License Number State | NJ
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