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Provider Information for 1730190372


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TRAN'S PHARMACY

Organization Subpart: NO

NPI: 1730190372
Last Updated: 2020-08-22
Certification Date:

Details

NameValue
NPI1730190372
Enumeration Date2006-08-10
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mr. NICK C TRAN RPH
Title: OWNER
Phone: 2284366425
Mailing Address 1025 DIVISION ST STE F
BILOXI, MS 39530-2910
United States

Phone: 228-436-6425 | Fax:228-436-6426
 
Primary Practice Address 1025 DIVISION ST STE F
BILOXI, MS 39530-2910
United States

Phone: 228-436-6425 | Fax:228-436-6426
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMS00330587
Other (non-Medicare)2520371Other ID Number-Commercial Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy MS04924011
No 3336C0003X - Pharmacy - Community/Retail Pharmacy