Provider Demographics
NPI:1477769636
Name:TRAN PHARMACY
Entity type:Organization
Organization Name:TRAN PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:V
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:971-244-1100
Mailing Address - Street 1:7816 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-6467
Mailing Address - Country:US
Mailing Address - Phone:971-244-1100
Mailing Address - Fax:971-244-1101
Practice Address - Street 1:7816 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-6467
Practice Address - Country:US
Practice Address - Phone:971-244-1100
Practice Address - Fax:971-244-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRP-0002017-CS183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR181489Medicaid
OR181489Medicaid