Provider Demographics
NPI:1124638846
Name:TRAN, TRAM NGOC
Entity type:Individual
Prefix:
First Name:TRAM
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 HERITAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1783
Mailing Address - Country:US
Mailing Address - Phone:513-727-7440
Mailing Address - Fax:513-727-7455
Practice Address - Street 1:3033 HERITAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1783
Practice Address - Country:US
Practice Address - Phone:513-727-7440
Practice Address - Fax:513-727-7455
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033288931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist