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NPI Code Detail

MEDICARE: KEVIN TUAN TRAN R.PH

MEDICARE: KEVIN TUAN TRAN R.PH
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
1183500000XPharmacistS011475AZ

General Provider Information

NPI Number : 1952741860
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN TUAN TRAN R.PH
Provider Business Mailing Address
First Line : 520 E BASELINE RD
Second Line : ATTENTION: PHARMACY
City : PHOENIX
State : AZ
Zip : 85042-6554
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 520 E BASELINE RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-6554
Country : US
Telephone Number : 602-243-3014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2013
Last Update Date : 12/15/2016

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