MEDICARE: QUOC N 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
1	183500000X	Pharmacist	10567	SC

General Provider Information

NPI Number	:	1396065462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUOC N TRAN

Provider Business Mailing Address
First Line	:	2446 HUDSON RD
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29650-2923
Country	:	US
Telephone Number	:	864-244-8893
Fax Number	:	864-268-9147

Provider Business Practice Location Address
First Line	:	2446 HUDSON RD
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29650-2923
Country	:	US
Telephone Number	:	864-244-8893
Fax Number	:	864-268-9147

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	06/10/2010

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