MEDICARE: FRANK DINH 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	RPH026108	GA

General Provider Information

NPI Number	:	1467828475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK DINH TRAN

Provider Business Mailing Address
First Line	:	895 HOLCOMB BRIDGE RD
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-1954
Country	:	US
Telephone Number	:	770-993-0194
Fax Number	:	770-992-9332

Provider Business Practice Location Address
First Line	:	895 HOLCOMB BRIDGE RD
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-1954
Country	:	US
Telephone Number	:	770-993-0194
Fax Number	:	770-992-9332

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

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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