MEDICARE: NGUYEN TRAN RPH

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	0202214296	VA

General Provider Information

NPI Number	:	1578949376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGUYEN TRAN RPH

Provider Business Mailing Address
First Line	:	4428 DEACONS LN
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6133
Country	:	US
Telephone Number	:	571-438-1477
Fax Number	:

Provider Business Practice Location Address
First Line	:	3813 GASKINS RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1436
Country	:	US
Telephone Number	:	804-747-7787
Fax Number	:

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

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	08/04/2015

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