Provider Demographics
NPI:1891078820
Name:OH, KYUNG MI (BS PHARM)
Entity Type:Individual
Prefix:
First Name:KYUNG MI
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:BS PHARM
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2595 PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9599
Mailing Address - Country:US
Mailing Address - Phone:678-455-4544
Mailing Address - Fax:678-455-7201
Practice Address - Street 1:2595 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9599
Practice Address - Country:US
Practice Address - Phone:678-455-4544
Practice Address - Fax:678-455-7201
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist