MEDICARE: DR. THANH BUI PHARMD.

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03337276	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03337276	OTHER	OH	OHIO BOARD OF PHARMACY LICENSE

General Provider Information

NPI Number	:	1811457146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THANH BUI PHARMD.

Provider Business Mailing Address
First Line	:	11333 CORNELL DRIVE
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242
Country	:	US
Telephone Number	:	513-354-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	11333 CORNELL PARK DR
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-1813
Country	:	US
Telephone Number	:	513-354-2554
Fax Number	:

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

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	03/22/2019

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