MEDICARE: JENNY TRAN ENTERPRISES, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1770719494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNY TRAN ENTERPRISES, INC

Provider Business Mailing Address
First Line	:	1017 MCCLELLAND CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1514
Country	:	US
Telephone Number	:	877-810-3237
Fax Number	:	704-632-1661

Provider Business Practice Location Address
First Line	:	1017 MCCLELLAND CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1514
Country	:	US
Telephone Number	:	877-810-3237
Fax Number	:	704-632-1661

Authorized Official
Title or Position	:	CEO
Name	:	MS. JENNIFER TRAN
Credential	:
Telephone Number	:	980-275-3675

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	06/09/2009

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