Provider Demographics
NPI:1619240199
Name:TRAN, QUYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:QUYEN
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 1:2711 GROVE AVE
Mailing Address - Street 2:UNIT 6
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4349
Mailing Address - Country:US
Mailing Address - Phone:412-657-6966
Mailing Address - Fax:
Practice Address - Street 1:2711 GROVE AVE
Practice Address - Street 2:UNIT 6
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4349
Practice Address - Country:US
Practice Address - Phone:412-657-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist