MEDICARE: MS. JANINE DUONG TRAN RPH

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	RP030855L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP00855L	OTHER	PA	REGISTERED PHARMACIST

General Provider Information

NPI Number	:	1922314558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANINE DUONG TRAN RPH

Provider Business Mailing Address
First Line	:	1100 VINE ST
Second Line	:	APT # P310
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-1731
Country	:	US
Telephone Number	:	215-669-6869
Fax Number	:

Provider Business Practice Location Address
First Line	:	1426 WALNUT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4016
Country	:	US
Telephone Number	:	215-545-8050
Fax Number	:

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

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/20/2010

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