MEDICARE: DR. THUY KIM LUONG PHARM D

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	17037	NV

General Provider Information

NPI Number	:	1609086222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THUY KIM LUONG PHARM D

Provider Business Mailing Address
First Line	:	9626 SWEET PALM CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8279
Country	:	US
Telephone Number	:	714-274-5202
Fax Number	:

Provider Business Practice Location Address
First Line	:	9626 SWEET PALM CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8279
Country	:	US
Telephone Number	:	714-274-5202
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/07/2013

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