Provider Demographics
NPI:1871863399
Name:HONG, JENNIFER J (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:HONG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2838
Mailing Address - Country:US
Mailing Address - Phone:224-234-4511
Mailing Address - Fax:
Practice Address - Street 1:11305 BELL RD
Practice Address - Street 2:STE 107
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-9503
Practice Address - Country:US
Practice Address - Phone:678-835-9997
Practice Address - Fax:678-835-9721
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03390900183500000X
AL19127183500000X
TX71886183500000X
GARPH025358183500000X
LAPST021424183500000X
WVRP0009469183500000X
KY018285183500000X
MST14136183500000X
TN39819183500000X
OKR15955183500000X
NE14803183500000X
VA0202213565183500000X
IL051291531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist