Provider Demographics
NPI:1043586639
Name:TRAN, TRAM HOANG VUONG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRAM
Middle Name:HOANG VUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4916 CHIMNEY OAKS DR SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5951
Mailing Address - Country:US
Mailing Address - Phone:678-386-5038
Mailing Address - Fax:
Practice Address - Street 1:4916 CHIMNEY OAKS DR SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5951
Practice Address - Country:US
Practice Address - Phone:678-386-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist