Provider Demographics
NPI:1568039592
Name:TRAN, MINA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:MINA
Middle Name:
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 1:9880 BUSTLETON AVE STE 332
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-2144
Mailing Address - Country:US
Mailing Address - Phone:215-827-1680
Mailing Address - Fax:215-827-1394
Practice Address - Street 1:9880 BUSTLETON AVE STE 332
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2144
Practice Address - Country:US
Practice Address - Phone:215-827-1680
Practice Address - Fax:215-827-1394
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist