Healthcare Provider Details

I. General information

NPI: 1427461490
Provider Name (Legal Business Name): ANN LAM CHAU RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2014
Last Update Date: 06/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1443 S 7TH ST
PHILADELPHIA PA
19147-5847
US

IV. Provider business mailing address

1109 SNYDER AVE
PHILADELPHIA PA
19148-5521
US

V. Phone/Fax

Practice location:
  • Phone: 215-463-7748
  • Fax: 215-463-3479
Mailing address:
  • Phone: 215-463-1018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038152L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: