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General NPI Number Information
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NPI Number | 1336026707
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Entity Type | Individual
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Provider Name | ANH TRONG QUOC TRAN
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Gender | Male
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 16901 LAKESIDE HILLS CT
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City | OMAHA
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State | NE
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Zip | 68130-2318
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Country | US
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Telephone | 402-717-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3219 N 170TH ST
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City | OMAHA
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State | NE
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Zip | 68116-2654
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Country | US
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Telephone | 402-805-5198
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18351
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License Number State | NE
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