Provider Demographics
NPI:1104593938
Name:VU, THIEN LONG HOANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THIEN LONG
Middle Name:HOANG
Last Name:VU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 WOLFRUM RD
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7625
Mailing Address - Country:US
Mailing Address - Phone:363-000-1586
Mailing Address - Fax:
Practice Address - Street 1:1003 WOLFRUM RD
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-7625
Practice Address - Country:US
Practice Address - Phone:636-300-0158
Practice Address - Fax:636-300-0172
Is Sole Proprietor?:No
Enumeration Date:2021-08-28
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021035026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist