Provider Demographics
NPI:1982843389
Name:KIM, JUNGEUN JOAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUNGEUN
Middle Name:JOAN
Last Name:KIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 E CAPITOL ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3809
Mailing Address - Country:US
Mailing Address - Phone:202-543-4400
Mailing Address - Fax:202-547-1314
Practice Address - Street 1:326 E CAPITOL ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3809
Practice Address - Country:US
Practice Address - Phone:202-543-4400
Practice Address - Fax:202-547-1314
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16959183500000X
DCPH100000988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPH100000988OtherPHARMACIST LICENSE
MD16959OtherPHARMACIST LICENSE