Provider Demographics
NPI:1487971800
Name:TRAN, JASON R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:TRAN
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 1:813 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15066-1914
Mailing Address - Country:US
Mailing Address - Phone:724-843-5440
Mailing Address - Fax:
Practice Address - Street 1:813 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:PA
Practice Address - Zip Code:15066-1914
Practice Address - Country:US
Practice Address - Phone:724-843-5440
Practice Address - Fax:724-891-7650
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438425183500000X
WVRP0006738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist