Provider Demographics
NPI:1093467888
Name:TRAN, KHOA D (PHARMD)
Entity Type:Individual
Prefix:
First Name:KHOA
Middle Name:D
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 1:3690 GRANDVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3326
Mailing Address - Country:US
Mailing Address - Phone:205-971-1455
Mailing Address - Fax:
Practice Address - Street 1:3690 GRANDVIEW PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3326
Practice Address - Country:US
Practice Address - Phone:205-971-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist