Provider Demographics
NPI:1386820488
Name:NA, HYUNG J (R PH)
Entity Type:Individual
Prefix:
First Name:HYUNG
Middle Name:J
Last Name:NA
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10805 HICKORY RIDGE RD
Mailing Address - Street 2:COLUMBIA HICKORY PHARMACY
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3626
Mailing Address - Country:US
Mailing Address - Phone:410-964-6409
Mailing Address - Fax:410-964-6493
Practice Address - Street 1:10805 HICKORY RIDGE RD
Practice Address - Street 2:COLUMBIA HICKORY PHARMACY
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3626
Practice Address - Country:US
Practice Address - Phone:410-964-6409
Practice Address - Fax:410-964-6493
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist