Provider Demographics
NPI:1073917449
Name:SUJU ENTERPRISE INC
Entity Type:Organization
Organization Name:SUJU ENTERPRISE INC
Other - Org Name:HANA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JA YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:KONGKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-878-2445
Mailing Address - Street 1:4195 PLEASANT HILL RD.SUITE D
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:678-878-2445
Mailing Address - Fax:678-878-2446
Practice Address - Street 1:4195 PLEASANT HILL RD.SUITE D
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:678-878-2445
Practice Address - Fax:678-878-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0100773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy