Organization
HYUNGWON KANG
Active
Other names
CORNER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HYUNGWON KANG (OWNER PIC)
(770) 622-0688
Entity
Organization
Contact information
Practice address
2550 PLEASANT HILL RD # BUILD100, STE 126, DULUTH, GA 30096-4122
(770) 622-0688
(770) 622-0689
Mailing address
2550 PLEASANT HILL RD # BUILD100, STE 126, DULUTH, GA 30096-4122
(770) 622-0688
(770) 622-0689
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008994
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1153864
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
422771904A
—
GA
Enumeration date
12/22/2005
Last updated
06/03/2011
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