Provider Demographics
NPI:1639506132
Name:TRAN, SON (PHARM D)
Entity Type:Individual
Prefix:
First Name:SON
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3951 SPRING LANDING CT
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-2528
Mailing Address - Country:US
Mailing Address - Phone:251-209-5294
Mailing Address - Fax:
Practice Address - Street 1:3150 BEL AIR MALL
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3206
Practice Address - Country:US
Practice Address - Phone:251-471-9768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist