MEDICARE: ANGELINE TRAN-VU

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	12470	OK

General Provider Information

NPI Number	:	1073113213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINE TRAN-VU

Provider Business Mailing Address
First Line	:	7800 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-1554
Country	:	US
Telephone Number	:	405-721-7260
Fax Number	:	405-721-7832

Provider Business Practice Location Address
First Line	:	7800 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-1554
Country	:	US
Telephone Number	:	405-721-7260
Fax Number	:

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

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/27/2020

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Directions to “ ANGELINE TRAN-VU ” Practice Location

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