Provider Demographics
NPI:1093004756
Name:JUNGLING, DEBORAH A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:JUNGLING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45940 HORSESHOE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6569
Mailing Address - Country:US
Mailing Address - Phone:703-406-6906
Mailing Address - Fax:703-406-6853
Practice Address - Street 1:45940 HORSESHOE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6569
Practice Address - Country:US
Practice Address - Phone:703-406-6906
Practice Address - Fax:703-406-6853
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10528183500000X
SC11309183500000X
VA0202011233183500000X
NC18018183500000X
AL15156183500000X
DEA1-0004139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist