MEDICARE: LI WEI LIN

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	28RI03602200	PA

General Provider Information

NPI Number	:	1942889761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LI WEI LIN

Provider Business Mailing Address
First Line	:	2113 BERWYN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-3304
Country	:	US
Telephone Number	:	267-871-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	5756 HARTFORD ST
Second Line	:
City	:	FORT DIX
State	:	NJ
Zip	:	08640
Country	:	US
Telephone Number	:	609-723-1100
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	04/07/2021

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Directions to “ LI WEI LIN ” Practice Location

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