MEDICARE: MS. KIEM THI BUI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS 345687	FL

General Provider Information

NPI Number	:	1003845744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIEM THI BUI RPH

Provider Business Mailing Address
First Line	:	16013 MUIRFIELD DR
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-2861
Country	:	US
Telephone Number	:	813-926-4441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 BRUCE B DOWNS BLVD
Second Line	:	13000
City	:	TAMPA
State	:	FL
Zip	:	33612-9217
Country	:	US
Telephone Number	:	813-926-4441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/08/2007

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