Provider Demographics
NPI:1316285752
Name:CHEN, HSUEH-JEN (RPH)
Entity type:Individual
Prefix:
First Name:HSUEH-JEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 BAKER RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4600
Mailing Address - Country:US
Mailing Address - Phone:678-331-8755
Mailing Address - Fax:678-331-8759
Practice Address - Street 1:2090 BAKER RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4600
Practice Address - Country:US
Practice Address - Phone:678-331-8755
Practice Address - Fax:678-331-8759
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist