MEDICARE: HOAI-PHUONG TRAN PHARMD

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	5302040326	MI

General Provider Information

NPI Number	:	1396373528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOAI-PHUONG TRAN PHARMD

Provider Business Mailing Address
First Line	:	2080 44TH ST SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49508-5299
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 44TH ST SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49508-5299
Country	:	US
Telephone Number	:	616-685-8100
Fax Number	:

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

Provider Enumeration Date	:	04/01/2020
Last Update Date	:	12/13/2021

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Directions to “ HOAI-PHUONG TRAN PHARMD” Practice Location

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