Healthcare Provider Details

I. General information

NPI: 1497156251
Provider Name (Legal Business Name): HUI EN HUANG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 MAIN ST
SOUTHBRIDGE MA
01550-3760
US

IV. Provider business mailing address

455 MAIN ST
SOUTHBRIDGE MA
01550-3760
US

V. Phone/Fax

Practice location:
  • Phone: 508-765-5922
  • Fax:
Mailing address:
  • Phone: 508-765-5922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST 020778
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH235431
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: