Provider Demographics
NPI:1407446776
Name:TRANTHAM, TANNER AUSTIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TANNER
Middle Name:AUSTIN
Last Name:TRANTHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4814 HOPEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-8177
Mailing Address - Country:US
Mailing Address - Phone:336-520-3227
Mailing Address - Fax:
Practice Address - Street 1:3800 GATEWAY CENTRE BLVD STE 308-A
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6220
Practice Address - Country:US
Practice Address - Phone:919-586-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty