MEDICARE: DR. JEFFREY LIU PHARMD

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	RP451253	PA

General Provider Information

NPI Number	:	1841775699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY LIU PHARMD

Provider Business Mailing Address
First Line	:	257 N 52ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1502
Country	:	US
Telephone Number	:	267-292-5011
Fax Number	:	267-292-5403

Provider Business Practice Location Address
First Line	:	257 N 52ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1502
Country	:	US
Telephone Number	:	267-292-5011
Fax Number	:	267-292-5403

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

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	09/27/2018

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