Provider Demographics
NPI:1730190372
Name:TRAN'S PHARMACY
Entity type:Organization
Organization Name:TRAN'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-436-6425
Mailing Address - Street 1:1025 DIVISION ST STE F
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-2910
Mailing Address - Country:US
Mailing Address - Phone:228-436-6425
Mailing Address - Fax:228-436-6426
Practice Address - Street 1:1025 DIVISION ST STE F
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2910
Practice Address - Country:US
Practice Address - Phone:228-436-6425
Practice Address - Fax:228-436-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS04924011333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2520371OtherOTHER ID NUMBER-COMMERCIAL NUMBER
MS00330587Medicaid
MS00330587Medicaid