Provider Demographics
NPI:1396291258
Name:VU, AMANDA (PHARM D)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13237 WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-1029
Mailing Address - Country:US
Mailing Address - Phone:504-453-3314
Mailing Address - Fax:
Practice Address - Street 1:4142 PONTCHARTRAIN DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5138
Practice Address - Country:US
Practice Address - Phone:985-649-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist