MEDICARE: ENNA NGUYEN 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	S024732	AZ

General Provider Information

NPI Number	:	1427668417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENNA NGUYEN TRAN

Provider Business Mailing Address
First Line	:	4821 N STONE AVE STE C
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5743
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4821 N STONE AVE STE C
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5743
Country	:	US
Telephone Number	:	833-396-0309
Fax Number	:

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

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	06/02/2026

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Directions to “ ENNA NGUYEN TRAN ” Practice Location

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