Healthcare Provider Details

I. General information

NPI: 1750139044
Provider Name (Legal Business Name): HUONG THI TRAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

3157 S QUAKER ST
MORRISON CO
80465-1596
US

V. Phone/Fax

Practice location:
  • Phone: 720-536-7888
  • Fax:
Mailing address:
  • Phone: 303-875-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number87611
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: