Provider Demographics
NPI:1609049808
Name:NGUYEN, QUOC AN TRAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:QUOC AN
Middle Name:TRAN
Last Name:NGUYEN
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 1:36 SUNRISE PARK
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-3135
Mailing Address - Country:US
Mailing Address - Phone:828-586-8961
Mailing Address - Fax:828-631-9783
Practice Address - Street 1:36 SUNRISE PARK
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-3135
Practice Address - Country:US
Practice Address - Phone:828-586-8961
Practice Address - Fax:828-631-9783
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18324183500000X
NC22297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist