Provider Demographics
NPI:1346659653
Name:TRAN, CHANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHANH
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 1:10550 BURBANK DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6468
Mailing Address - Country:US
Mailing Address - Phone:225-412-5498
Mailing Address - Fax:225-412-5499
Practice Address - Street 1:10550 BURBANK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6468
Practice Address - Country:US
Practice Address - Phone:225-412-5498
Practice Address - Fax:225-412-5499
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.019522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist