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NPI Code Detail

MEDICARE: PHUC TRAN

MEDICARE: PHUC TRAN
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
1183500000XPharmacist020708LA

General Provider Information

NPI Number : 1275942575
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHUC TRAN
Provider Business Mailing Address
First Line : 3445 MARYLAND AVE
Second Line :
City : KENNER
State : LA
Zip : 70065-3812
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2308 S RANGE AVE
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-5216
Country : US
Telephone Number : 225-664-5099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2014
Last Update Date : 08/12/2014

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Directions to “ PHUC TRAN ” Practice Location

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