MEDICARE: ANTOINE VU

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	18625	NV

General Provider Information

NPI Number	:	1356934749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINE VU

Provider Business Mailing Address
First Line	:	8827 WINTER SKY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3634 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3033
Country	:	US
Telephone Number	:	844-928-3659
Fax Number	:

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

Provider Enumeration Date	:	02/16/2021
Last Update Date	:	02/16/2021

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Directions to “ ANTOINE VU ” Practice Location

Language	Start Address	Practice Location

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