MEDICARE: LOC TAN TRAN PHARM-D

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	14361	NV

General Provider Information

NPI Number	:	1902829062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOC TAN TRAN PHARM-D

Provider Business Mailing Address
First Line	:	5694 CALANAS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3951
Country	:	US
Telephone Number	:	702-809-3061
Fax Number	:	702-454-3053

Provider Business Practice Location Address
First Line	:	3760 E SUNSET RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3233
Country	:	US
Telephone Number	:	702-458-4004
Fax Number	:	702-454-3053

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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Directions to “ LOC TAN TRAN PHARM-D” Practice Location

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