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NPI Code Detail

MEDICARE: TUAN TRAN

MEDICARE: TUAN 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
1183500000XPharmacist26027167AIN

General Provider Information

NPI Number : 1316543168
Entity Type Code : Individual
Provider Name (Legal Business Name) : TUAN TRAN
Provider Business Mailing Address
First Line : 2802 EAST STATE BLVD.
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805
Country : US
Telephone Number : 260-471-5521
Fax Number :
Provider Business Practice Location Address
First Line : 2802 E STATE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4733
Country : US
Telephone Number : 260-471-5521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2020
Last Update Date : 12/08/2020

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Directions to “ TUAN TRAN ” Practice Location

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