MEDICARE: WON H SUH RPH

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	38977	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326223918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WON H SUH RPH

Provider Business Mailing Address
First Line	:	1540 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-8400
Country	:	US
Telephone Number	:	718-731-8733
Fax Number	:	718-731-8809

Provider Business Practice Location Address
First Line	:	1540 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-8400
Country	:	US
Telephone Number	:	718-731-8733
Fax Number	:	718-731-8809

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	01/02/2008

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Directions to “ WON H SUH RPH” Practice Location

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