MEDICARE: CHI M HANG RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI025480000	NJ

General Provider Information

NPI Number	:	1285623215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI M HANG RPH

Provider Business Mailing Address
First Line	:	105 AUTUMN RD
Second Line	:
City	:	MATAWAN
State	:	NJ
Zip	:	07747-3594
Country	:	US
Telephone Number	:	732-532-5511
Fax Number	:	732-532-0194

Provider Business Practice Location Address
First Line	:	1075 STEPHENSON AVE
Second Line	:
City	:	FORT MONMOUTH
State	:	NJ
Zip	:	07703
Country	:	US
Telephone Number	:	732-532-5511
Fax Number	:	732-532-0194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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