Individual ProviderMin Ji AhnPharmacistPharmacy Service ProvidersPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809(707) 423-7657(707) 423-3000PECOS EnrollmentBased on the most recent information from CMS, provider Min Ji Ahn does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:10 AM.Profile DetailsProvider ID1356827224Provider TypeIndividualFull NameAhn, Min JiGenderFemaleSole ProprietorNoEnumeration Date7/13/2018Last Updated12/16/2020Contact InformationPractice LocationPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7657FaxUnlisted FaxMailing LocationMailing Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-3000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense0202214452Virginia