Provider Demographics
NPI:1053728444
Name:WU, VINCENT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:WU
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 1:9440 ARBORIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-5218
Mailing Address - Country:US
Mailing Address - Phone:513-316-9839
Mailing Address - Fax:
Practice Address - Street 1:9440 ARBORIDGE LN
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-5218
Practice Address - Country:US
Practice Address - Phone:513-316-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist