MEDICARE: NHATVY TRAN

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	RP459057	PA

General Provider Information

NPI Number	:	1205644788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NHATVY TRAN

Provider Business Mailing Address
First Line	:	5012 OLD YORK RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-2707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-4004
Country	:	US
Telephone Number	:	484-802-0186
Fax Number	:

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

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	12/30/2024

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Directions to “ NHATVY TRAN ” Practice Location

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