Organization
SAM'S CLUB/WALMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTY THANHVAN TRAN PHARMD (RELIEF STAFF PHARMACIST)
(480) 364-1568
Entity
Organization
Contact information
Practice address
1375 S ARIZONA AVE, CHANDLER, AZ 85286-6500
(480) 364-1568
Mailing address
4038 N TERRA MESA CIR, MESA, AZ 85207-1475
(480) 364-1568
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
S013076
AZ
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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