MEDICARE: VAN ANH TRAN PHARM D

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	PD08998	AR

General Provider Information

NPI Number	:	1144591942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAN ANH TRAN PHARM D

Provider Business Mailing Address
First Line	:	1103 B ST
Second Line	:
City	:	BARLING
State	:	AR
Zip	:	72923-2422
Country	:	US
Telephone Number	:	479-709-8941
Fax Number	:	479-709-8951

Provider Business Practice Location Address
First Line	:	4001 PHOENIX AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-6099
Country	:	US
Telephone Number	:	479-709-8941
Fax Number	:	479-709-8951

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

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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Directions to “ VAN ANH TRAN PHARM D” Practice Location

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