=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134526379
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YONGMU HUANG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2014
-----------------------------------------------------
Last Update Date | 12/03/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1120 S CENTRAL AVE
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19956-1418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-875-7844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23069 MEADOW WOOD CT UNIT 321
-----------------------------------------------------
City | SEAFORD
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19973-7745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | A1-0004666
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------