Provider Demographics
NPI:1518691591
Name:DAEHAN YAKBANG RX, INC.
Entity Type:Organization
Organization Name:DAEHAN YAKBANG RX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-799-0723
Mailing Address - Street 1:15001 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3896
Mailing Address - Country:US
Mailing Address - Phone:718-799-0723
Mailing Address - Fax:718-799-0731
Practice Address - Street 1:15001 NORTHERN BLVD
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3896
Practice Address - Country:US
Practice Address - Phone:718-799-0723
Practice Address - Fax:718-799-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy