Provider Demographics
NPI:1710314406
Name:JUNG, LAUREN ALLIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ALLIA
Last Name:JUNG
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 1:106 EAST DR. MARTIN LUTHER KING JR. DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364
Mailing Address - Country:US
Mailing Address - Phone:910-844-3096
Mailing Address - Fax:
Practice Address - Street 1:106 EAST DR. MARTIN LUTHER KING JR. DR.
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364
Practice Address - Country:US
Practice Address - Phone:910-844-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist