MEDICARE: WANG SHIANG LEE 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	RPH04602	RI

General Provider Information

NPI Number	:	1770867616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WANG SHIANG LEE PHARM.D

Provider Business Mailing Address
First Line	:	1010 PARK AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-3244
Country	:	US
Telephone Number	:	401-946-0337
Fax Number	:	401-464-9740

Provider Business Practice Location Address
First Line	:	1010 PARK AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-3244
Country	:	US
Telephone Number	:	401-946-0337
Fax Number	:	401-464-9740

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

Provider Enumeration Date	:	10/10/2011
Last Update Date	:	10/10/2011

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