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General NPI Number Information
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NPI Number | 1871434126
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Entity Type | Individual
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Provider Name | TIFFANY VU
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 2720 E PONCE DE LEON AVE
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City | DECATUR
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State | GA
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Zip | 30030-2715
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Country | US
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Telephone | 404-378-9225
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Fax |
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Provider Business Mailing Address
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Address Line | 5930 PELTIER TRCE
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City | NORCROSS
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State | GA
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Zip | 30093-5777
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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 | RPH035973
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License Number State | GA
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