Provider Demographics
NPI:1477847143
Name:TRAN, THUAN V (RPH)
Entity Type:Individual
Prefix:MR
First Name:THUAN
Middle Name:V
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:DR
Other - First Name:THUAN
Other - Middle Name:VAN
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JD
Mailing Address - Street 1:819 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3426
Mailing Address - Country:US
Mailing Address - Phone:801-465-0363
Mailing Address - Fax:801-465-0379
Practice Address - Street 1:819 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-3426
Practice Address - Country:US
Practice Address - Phone:801-465-0363
Practice Address - Fax:801-465-0379
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT146671-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist