Provider Demographics
NPI:1265807655
Name:OHGREEN PHYTOCEUTICALS INC
Entity type:Organization
Organization Name:OHGREEN PHYTOCEUTICALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:
Authorized Official - Last Name:HUA
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:954-237-1358
Mailing Address - Street 1:3402 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5564
Mailing Address - Country:US
Mailing Address - Phone:954-237-1358
Mailing Address - Fax:
Practice Address - Street 1:3402 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5564
Practice Address - Country:US
Practice Address - Phone:954-237-1358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty