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THANG NGOC TON VU

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1134723299

Individual Registrant:
 THANG NGOC TON VU 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1141 STATE ROAD 20  INTERLACHEN, FL 32148-5406 US
Tel: 386-684-4991  Fax: 386-684-3029

Contact information for business:
1141 STATE ROAD 20  INTERLACHEN, FL 32148-5406 US
Tel: 386-684-4991  Fax: 386-684-3029

Registration Information:
NPI: 1134723299
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
FLPS59061

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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