Healthcare Provider Details

I. General information

NPI: 1043761034
Provider Name (Legal Business Name): SHUJING CHEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3703 LAWNDALE DR
GREENSBORO NC
27455
US

IV. Provider business mailing address

5801 GARDEN VILLAGE CT APT J
GREENSBORO NC
27410-8706
US

V. Phone/Fax

Practice location:
  • Phone: 336-540-1344
  • Fax:
Mailing address:
  • Phone: 917-803-9753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26536
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: