Provider Demographics
NPI:1386249068
Name:TRAN, ANH-THO THI
Entity type:Individual
Prefix:
First Name:ANH-THO
Middle Name:THI
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 1:14324 COMPTON RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2711
Mailing Address - Country:US
Mailing Address - Phone:703-815-8516
Mailing Address - Fax:
Practice Address - Street 1:15250 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2952
Practice Address - Country:US
Practice Address - Phone:703-753-1032
Practice Address - Fax:703-753-1510
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist