Provider Demographics
NPI:1841581386
Name:WOO, EUGENE III (RPH)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:WOO
Suffix:III
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 1:1550 KENNESAW DUE WEST RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4338
Mailing Address - Country:US
Mailing Address - Phone:770-423-9525
Mailing Address - Fax:
Practice Address - Street 1:1550 KENNESAW DUE WEST RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4338
Practice Address - Country:US
Practice Address - Phone:770-423-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2011-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist