MEDICARE: DR. KATHRYN WOGE 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	28RI03292200	NJ

General Provider Information

NPI Number	:	1124300603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN WOGE PHARM. D.

Provider Business Mailing Address
First Line	:	2 N VIRGINIA AVE
Second Line	:
City	:	PENNS GROVE
State	:	NJ
Zip	:	08069-1427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 N VIRGINIA AVE
Second Line	:
City	:	PENNS GROVE
State	:	NJ
Zip	:	08069-1427
Country	:	US
Telephone Number	:	856-299-0744
Fax Number	:

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

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	09/12/2011

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