Provider Demographics
NPI:1700108099
Name:KHANG, TOU SHONPOV (RPH)
Entity Type:Individual
Prefix:MR
First Name:TOU
Middle Name:SHONPOV
Last Name:KHANG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 10TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-2339
Mailing Address - Country:US
Mailing Address - Phone:828-464-0181
Mailing Address - Fax:828-464-7811
Practice Address - Street 1:508 10TH ST NW
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-2339
Practice Address - Country:US
Practice Address - Phone:828-464-0181
Practice Address - Fax:828-464-7811
Is Sole Proprietor?:No
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC139141835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric