MEDICARE: MS. TOI KAN WONG

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	S010045	AZ

General Provider Information

NPI Number	:	1437329299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TOI KAN WONG

Provider Business Mailing Address
First Line	:	2502 W BOVINO WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 W BOVINO WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3102
Country	:	US
Telephone Number	:	520-797-3096
Fax Number	:

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

Provider Enumeration Date	:	03/08/2008
Last Update Date	:	03/08/2008

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