Provider Demographics
NPI:1982032728
Name:HONG, NOEL (RPH)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:HONG
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 1:32590 WHITING RD
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54814-4408
Mailing Address - Country:US
Mailing Address - Phone:715-779-5891
Mailing Address - Fax:715-682-4004
Practice Address - Street 1:1800 US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806
Practice Address - Country:US
Practice Address - Phone:715-682-8306
Practice Address - Fax:715-682-4004
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113572183500000X
WI11273-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist