Active NPI
Douglas Wong
- Pharmacist
- North Wales, PA
National Provider Identifier
1194130062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30301
- Practice address
- 700 E Kennedy Rd
North Wales, PA 19454-5612 - Phone
- (215) 628-0867
- Fax
- (845) 483-1649
- NPI assigned
- Jun 30, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30301 | CA | Primary |
| Pharmacist | 183500000X | RP043566R | PA | |
| Pharmacist | 183500000X | PH18267 | MA | |
| Pharmacist | 183500000X | 06823 | NV |
Addresses
Primary practice location
700 E Kennedy Rd
North Wales, PA 19454-5612
Mailing address
700 E Kennedy Rd
North Wales, PA 19454-5612
Phone (215) 628-0867
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30301 | CA | MD | Mental Health Counselor |
| PH18267 | MA | MD | Pharmacist |
| 06823 | NV | MD | Pharmacist |
| RP043566R | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489363200000",
"number": "1194130062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E KENNEDY RD",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "194545612",
"telephone_number": "215-628-0867",
"fax_number": "845-483-1649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E KENNEDY RD",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "194545612",
"telephone_number": "215-628-0867",
"fax_number": "845-483-1649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "DOUGLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-30",
"last_updated": "2017-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "30301",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP043566R",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH18267",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "06823",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Wales, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.