MEDICARE: DR. EUN PYUNG PHILIP IM PHARM.D.

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	RPH028299	GA

General Provider Information

NPI Number	:	1871992651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUN PYUNG PHILIP IM PHARM.D.

Provider Business Mailing Address
First Line	:	7900 LINDBERGH BLVD APT 3301
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2006
Country	:	US
Telephone Number	:	706-248-2029
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2317
Country	:	US
Telephone Number	:	267-292-9323
Fax Number	:

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

Provider Enumeration Date	:	08/18/2014
Last Update Date	:	07/25/2016

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