MEDICARE: MR. HUNG LUU 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	RP444635	PA

General Provider Information

NPI Number	:	1942515655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HUNG LUU PHARM.D

Provider Business Mailing Address
First Line	:	2401 E VENANGO ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4620
Country	:	US
Telephone Number	:	215-743-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 E VENANGO ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4620
Country	:	US
Telephone Number	:	215-743-8530
Fax Number	:

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

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	08/18/2010

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