Provider Demographics
NPI:1174342364
Name:NGO, TRAN H (PHARMD)
Entity type:Individual
Prefix:
First Name:TRAN
Middle Name:H
Last Name:NGO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 W CAVALIER DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-4435
Mailing Address - Country:US
Mailing Address - Phone:602-710-3418
Mailing Address - Fax:
Practice Address - Street 1:9245 W UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-8154
Practice Address - Country:US
Practice Address - Phone:623-972-8425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist