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General NPI Number Information
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NPI Number | 1336317544
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Entity Type | Individual
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Provider Name | DAT THANH TRAN B.S. PHARMACY
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Gender | Male
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 2401 CLEANLEIGH DR
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City | PARKVILLE
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State | MD
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Zip | 21234-6808
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Country | US
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Telephone | 410-668-0980
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Fax | 410-668-1599
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Provider Business Mailing Address
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Address Line | 1704 FALLSTON RD
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City | FALLSTON
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State | MD
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Zip | 21047-1415
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Country | US
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Telephone | 443-455-0410
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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 | 28RI02184800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 12735
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License Number State | MD
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