Provider Demographics
NPI:1104399518
Name:JOHNSTON, COURTNEY HONG (PHARM D)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:HONG
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E SUNFLOWER RD STE 100D
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2828
Mailing Address - Country:US
Mailing Address - Phone:662-843-4214
Mailing Address - Fax:662-843-3398
Practice Address - Street 1:810 E SUNFLOWER RD STE 100D
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2828
Practice Address - Country:US
Practice Address - Phone:662-843-4214
Practice Address - Fax:662-843-3398
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE13509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist