MEDICARE: CHAU K TRUONG R.PH.

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	16412	NV

General Provider Information

NPI Number	:	1487026597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAU K TRUONG R.PH.

Provider Business Mailing Address
First Line	:	6310 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1128
Country	:	US
Telephone Number	:	702-870-7271
Fax Number	:	702-870-7659

Provider Business Practice Location Address
First Line	:	6310 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1128
Country	:	US
Telephone Number	:	702-870-7271
Fax Number	:	702-870-7659

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

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	10/28/2015

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Directions to “ CHAU K TRUONG R.PH.” Practice Location

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