Provider Demographics
NPI:1033886429
Name:TRAN, TOMMY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 BRECKINRIDGE BLVD APT 1106
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-7651
Mailing Address - Country:US
Mailing Address - Phone:224-595-0178
Mailing Address - Fax:
Practice Address - Street 1:2750 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-2867
Practice Address - Country:US
Practice Address - Phone:770-622-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297710183500000X
GARPH032924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist