JUN PARK (NPI# 1275858672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275858672 |
| Entity Type | Individual |
| Full Name | JUN PARK |
| Practice Address |
500 Indiana Ave Winslow AZ 86047-2169 |
| Mailing Address |
5303 E Cortland Blvd Apt # R6 Flagstaff AZ 86004-9564 |
| Practice Telephone | 6155873416 |
| Mailing Telephone | 6155873416 |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2014-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 33359 | TN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043744279 | Jun Park | Internal Medicine | 4150 V Street, Pssb, Suite G400, Sacramento, CA 95817 | 2017-04-13 |
| 1548443831 | Jun Young Park | Dentist | 2030 Liberty Rd Ste 1, Eldersburg, MD 21784-6129 | 2007-12-10 |
| 1922578962 | Jun Hong Park | Case Manager/Care Coordinator | 600 St Paul Ave Ste 101, Los Angeles, CA 90017-5660 | 2018-12-03 |
| 1831687730 | Jun Park | Pharmacist | 711 Pier Ave, Hermosa Beach, CA 90254-3941 | 2018-04-25 |
| 1891022752 | Jun Sang Park | Chiropractor | 704 Dekalb Pike, Blue Bell, PA 19422-1214 | 2009-11-12 |
| 1952540908 | Jun Kyu Park | Anesthesiology | 7300 Medical Center Dr, West Hills, CA 91307-1902 | 2009-02-16 |
| 1497925739 | Jun Hyeong Park | Dentist | 2710 Telegraph Ave, 250, Oakland, CA 94612 | 2008-03-03 |
| 1437333515 | Jun Tae Park | Psychiatry & Neurology | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2007-12-24 |
| 1063553022 | Jun Park | Dentist | 4141 State St, Suite C-2 Dental, Santa Barbara, CA 93110-1814 | 2007-02-10 |
| Street Address |
500 INDIANA AVE |
| City | WINSLOW |
| State | AZ |
| Zip Code | 86047-2169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912534 | Christian Jay Thompson | Optometrist | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2005-06-21 |
| 1548886955 | Lily Chen | Student in an Organized Health Care Education/Training Program | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-06-22 |
| 1528682929 | Jaeseong Park | Student in an Organized Health Care Education/Training Program | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-06-01 |
| 1548881469 | Chadd Joseph Hiatt | Nurse Practitioner | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-05-01 |
| 1205465390 | Lindsay Dara Hughes | Student in an Organized Health Care Education/Training Program | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-04-02 |
| 1588290514 | Matthew Lee | Student in an Organized Health Care Education/Training Program | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-03-21 |
| 1669008082 | Deepa Patel | Student in an Organized Health Care Education/Training Program | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2020-03-17 |
| 1104487222 | Alex Stanco | Dentist | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2019-06-28 |
| 1881254423 | Kerry Lynn Cordier | Registered Nurse | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2019-06-17 |
| 1174182760 | Jorge Phillip Kinds | Registered Nurse | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2019-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097350 | Kalp Juthani | Student in an Organized Health Care Education/Training Program | 500 N Indiana Avenue, Winslow, AZ 86047 | 2020-03-11 |
| 1104461268 | Dental Innovations-winslow | Clinic/Center | 722 Mike's Pike Street, #101, Winslow, AZ 86047 | 2019-11-13 |
| 1417505611 | Association of Indigenous Pioneers, Incorporated (aipi) | Non-emergency Medical Transport (VAN) | Nec Navajo Route 15 & 60, Suite #2, Winslow, AZ 86047 | 2019-08-30 |
| 1790347573 | Wilfred Shirley | Counselor | 1/2 Mile Northeast Dilkon Bashas Store, Winslow, AZ 86047 | 2019-07-02 |
| 1871055624 | Mark Ashcraft | Student in an Organized Health Care Education/Training Program | Winslow Indian Health Care Center, 500 North Indiana Ave, Winslow, AZ 86047 | 2019-04-02 |
| 1568928521 | Winslow Indian Health Care Center, Inc | Pharmacy | 1.5 Mile N. Leupp Chapter House, Leupp, AZ 86047 | 2019-02-14 |
| 1659837615 | Winslow Indian Health Care Center, Inc | Pharmacy | 3 Mls S. of Dilkon Chapter Hse., Dilkon, AZ 86047 | 2019-02-14 |
| 1750809836 | Grassroots Medical Supply | Durable Medical Equipment & Medical Supplies | Nec Navajo Route 15 and 60, Suite #2, Winlsow, AZ 86047 | 2017-09-08 |
| 1538697396 | Janell K Dickson | Counselor | 1/4 Mile Ne of Bashas, Dilkon, AZ 86047 | 2017-05-24 |
| 1235599143 | Dennis Peters | Veterinarian | 4301 W Highway 66, Winslow, AZ 86047 | 2016-03-04 |
| Find all providers in zip 86047 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174058580 | Nathaniel B Johnson | Pharmacist | 24 Lithgow St, Winslow, ME 04901-7149 | 2017-04-23 |
| 1275990640 | Justin Russell Dorotheo | Pharmacist | Winslow Indian Healthcare Center (pharmacy Dept.), 500 Indiana Ave, Winslow, AZ 86047-7403 | 2016-01-15 |
| 1801140389 | Daniel Milovich | Pharmacist | 1601 N. Park Dr, Winslow, AZ 86024 | 2012-11-05 |
| 1780997189 | Sudhir Dabbas | Pharmacist | 36 China Rd, Winslow, ME 04901-7246 | 2010-07-14 |
| 1851555908 | Patricia Dee Wilke | Pharmacist | 2640 W Third St, Winslow, AZ 86047-2102 | 2008-07-17 |
| 1437149051 | Carmen Cirilo Clelland | Pharmacist | 333 W Mahoney St, Winslow, AZ 86047-2633 | 2005-10-25 |
| 1831704097 | Christopher Richard Nalepa | Pharmacist | 20 Garland Rd, Winslow, ME 04901-0600 | 2020-09-14 |
| 1033769302 | Brian Ma | Pharmacist | 500 N Indiana Ave, Winslow, AZ 86047-8604 | 2019-09-18 |
| 1932671377 | Ruth Choi | Pharmacist | 500 N Indiana Ave, Winslow, AZ 86047 | 2018-12-26 |
| 1447768676 | Brian Trinh | Pharmacist | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2018-01-22 |
| Find all providers in WINSLOW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.