Provider Demographics
NPI:1154679967
Name:WONG, YIN LAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YIN
Middle Name:LAM
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:YIN
Other - Middle Name:YUK
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:229 W BUFORD ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-2357
Mailing Address - Country:US
Mailing Address - Phone:864-489-3148
Mailing Address - Fax:
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6779
Practice Address - Fax:864-560-7316
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist