Provider Demographics
NPI:1053693150
Name:TRUONG, NGAN T (PHARMD)
Entity type:Individual
Prefix:
First Name:NGAN
Middle Name:T
Last Name:TRUONG
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 1:1300 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1898
Mailing Address - Country:US
Mailing Address - Phone:937-743-9609
Mailing Address - Fax:937-743-9679
Practice Address - Street 1:1300 E 2ND ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1898
Practice Address - Country:US
Practice Address - Phone:937-743-9609
Practice Address - Fax:937-743-9679
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist