Organization
DOUGIE FRESH INC
Active
Other names
Haeun Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEOG KIM (OWNER)
(215) 635-6532
Entity
Organization
Contact information
Practice address
7300 OLD YORK RD, STE 210, MELROSE PARK, PA 19027-3037
(215) 635-6532
(215) 635-2745
Mailing address
7300 OLD YORK RD, STE 210, MELROSE PARK, PA 19027-3037
(215) 635-6532
(215) 635-2745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481283
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027895800001
—
PA
01
—
2138837
PK
—
Enumeration date
10/31/2006
Last updated
03/28/2017
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