Provider Demographics
NPI:1538697420
Name:HONG, VORLAK
Entity Type:Individual
Prefix:
First Name:VORLAK
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 SEWARD AVE NW STE 320
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-5190
Mailing Address - Country:US
Mailing Address - Phone:616-267-7029
Mailing Address - Fax:616-391-9085
Practice Address - Street 1:8333 FELCH ST STE 200
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2609
Practice Address - Country:US
Practice Address - Phone:616-748-2850
Practice Address - Fax:616-748-2855
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0239321835P0018X
MI53020439081835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist