Provider Demographics
NPI:1669245742
Name:TRAN, LINH KHANH (RPH)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:KHANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 BRADFORD DR APT 215
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5435
Mailing Address - Country:US
Mailing Address - Phone:614-961-9559
Mailing Address - Fax:
Practice Address - Street 1:5016 OLD TAR RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8436
Practice Address - Country:US
Practice Address - Phone:252-321-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist