Provider Demographics
NPI:1245676550
Name:THAN, TRANG (PHARMD)
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:
Last Name:THAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:THUY TRANG
Other - Middle Name:THI
Other - Last Name:THAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:235 HOOVER CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2140
Mailing Address - Country:US
Mailing Address - Phone:303-945-0492
Mailing Address - Fax:
Practice Address - Street 1:633 S FEDERAL BLVD STE 203
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2975
Practice Address - Country:US
Practice Address - Phone:303-936-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist