Charleen Bao Tran Phan-Cao, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

14967 Issued in NE

Practice address

4808 O St
Lincoln, NE 68510-1908

Phone

(402) 467-1134

NPI assigned

Aug 3, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Charleen Bao Tran Phan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nebraska CVS Pharmacy LLC

  • Community/Retail Pharmacy
  • Lincoln, NE
  • NPI 1750599296
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1558971853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 S 80TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163813",
            "telephone_number": "402-617-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 O ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101908",
            "telephone_number": "402-467-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN-CAO",
        "first_name": "CHARLEEN",
        "middle_name": "BAO TRAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "14967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLEEN",
            "last_name": "PHAN",
            "middle_name": "BAO TRAN",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tam Pham
• Theodore Pham, DO
• Thi Kim Lien Pham
• Thunguyet Thi Pham
• Vicky Pham
• Myhanh Thi Phan-Rinne, D.D.S.
• Lien Le Phan
• Pharmacy Solutions Inc
• Pharmscript of NE LLC
• Caitlin Phelps, LMHP

• Pharmacist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Pharmacist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.