MEDICARE: TRANG QUYNH 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	19185	MD

General Provider Information

NPI Number	:	1699318089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRANG QUYNH TRAN

Provider Business Mailing Address
First Line	:	7716 SUTHARD DR
Second Line	:
City	:	DERWOOD
State	:	MD
Zip	:	20855-1138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17651 REDLAND RD
Second Line	:
City	:	DERWOOD
State	:	MD
Zip	:	20855-1236
Country	:	US
Telephone Number	:	301-330-9333
Fax Number	:

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

Provider Enumeration Date	:	10/18/2019
Last Update Date	:	10/18/2019

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