MEDICARE: SHUO CHEN PHARMD

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	28RI03821300	NJ

General Provider Information

NPI Number	:	1568913358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUO CHEN PHARMD

Provider Business Mailing Address
First Line	:	30 N ALBANY AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-3509
Country	:	US
Telephone Number	:	609-430-8308
Fax Number	:	609-344-1376

Provider Business Practice Location Address
First Line	:	30 N ALBANY AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-3509
Country	:	US
Telephone Number	:	609-430-8308
Fax Number	:	609-344-1376

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

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/18/2016

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