Provider Demographics
NPI:1538130968
Name:PARK, ANNA JIN-HEE (MS,RPH, RAC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:JIN-HEE
Last Name:PARK
Suffix:
Gender:F
Credentials:MS,RPH, RAC
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:JIN-HEE
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RPH,RAC
Mailing Address - Street 1:8901 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-796-1129
Mailing Address - Fax:301-796-9841
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889
Practice Address - Country:US
Practice Address - Phone:301-295-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist