Provider Demographics
NPI:1144374679
Name:TRAN PHARMACY INC
Entity type:Organization
Organization Name:TRAN PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-486-0445
Mailing Address - Street 1:2655 S 70TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2908
Mailing Address - Country:US
Mailing Address - Phone:402-486-0445
Mailing Address - Fax:402-486-0447
Practice Address - Street 1:2655 S 70TH ST
Practice Address - Street 2:STE C
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2908
Practice Address - Country:US
Practice Address - Phone:402-486-0445
Practice Address - Fax:402-486-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 3336C0003X
NE2766333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025533900Medicaid
2055440OtherPK
6015870001Medicare NSC