Provider Demographics
NPI:1407286487
Name:SUNG, JIN SOOK (PHARMD)
Entity Type:Individual
Prefix:
First Name:JIN SOOK
Middle Name:
Last Name:SUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3424
Mailing Address - Country:US
Mailing Address - Phone:703-236-0432
Mailing Address - Fax:
Practice Address - Street 1:4060 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3424
Practice Address - Country:US
Practice Address - Phone:703-236-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist