JONG-BEAK PARK (NPI# 1679717144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679717144 |
| Entity Type | Individual |
| Full Name | JONG-BEAK PARK |
| Credential | R.PH., PH.D. |
| Practice Address |
2263 Cedar St Holt MI 48842-1202 |
| Mailing Address |
5172 Madison Ave Apt C08 Okemos MI 48864-5118 |
| Practice Telephone | 5176942179 |
| Practice Fax Number | 5176942520 |
| Mailing Telephone | 5173475664 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2009-04-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302038479 | MI | Pharmacy Service Providers |
| Street Address |
2263 CEDAR ST |
| City | HOLT |
| State | MI |
| Zip Code | 48842-1202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164970810 | Jennifer Lamonica | Pharmacist | 2263 Cedar St, Holt, MI 48842-1202 | 2016-09-12 |
| 1457792558 | Luke Michael Hemingway | Pharmacist | 2263 Cedar St, Holt, MI 48842-1202 | 2013-07-17 |
| 1558653659 | David Nicholas Subu | Pharmacist | 2263 Cedar St, Holt, MI 48842-1202 | 2011-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730708538 | Dylan Voris | Psychologist | 4523 E Willoughby Rd., Holt, MI 48842 | 2020-04-11 |
| 1013458835 | Allison Ann Pingston | Specialist/Technologist | 23747 Rolling Ridge Ln., Holt, MI 48842 | 2017-03-13 |
| 1528417706 | Marybeth Timotiwu | Technician, Other | 3940 Acorn Cir, Holt, MI 48842 | 2016-06-08 |
| 1831593623 | Mary Nelson | Rehabilitation Practitioner | 3860 Wachtel Drive, Holt, MI 48842 | 2014-10-22 |
| 1598869703 | Nicole Elizabeth Durnin | Pharmacist | 2018 N. Cedar Street, Suite A, Holt, MI 48842 | 2006-09-08 |
| 1225130560 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2240 Cedar St, Holt, MI 48842 | 2006-09-05 |
| 1073622973 | Marilyn Viera | Family Medicine | 2380 Cedat St, Holt, MI 48842 | 2006-08-30 |
| 1942228291 | Stephen N. Glover | Pharmacist | 2390 N. Cedar St., Holt, MI 48842 | 2006-07-17 |
| 1740244169 | Pamela Thompson | Family Medicine | 4221 Charlar Dr, Holt, MI 48842 | 2006-04-13 |
| 1407847387 | Amy Lynn Cousineau | Optometrist | 2040 Aurelius Rd Ste 20, Holt, MI 48842 | 2005-10-31 |
| Find all providers in zip 48842 | ||||
| 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 |
|---|---|---|---|---|
| 1366871170 | Nadia Lorenzen | Pharmacist | 3545 Observatory Ln, Holt, MI 48842-9429 | 2013-11-02 |
| 1588901433 | Terry Ladon Gordon | Pharmacist | 498 Yellow River Ln, Holt, FL 32564-9570 | 2013-01-12 |
| 1437418480 | Benjamin Martin Greathouse | Pharmacist | 2240 N Cedar St., Holt, MI 48854-1201 | 2012-05-11 |
| 1659477982 | Amy L Kirkconnell | Pharmacist | 2018 Cedar St, Suite A, Holt, MI 48842-1400 | 2006-09-15 |
| 1598869703 | Nicole Elizabeth Durnin | Pharmacist | 2018 N. Cedar Street, Suite A, Holt, MI 48842 | 2006-09-08 |
| 1942228291 | Stephen N. Glover | Pharmacist | 2390 N. Cedar St., Holt, MI 48842 | 2006-07-17 |
| 1356975403 | Brett Rapp | Pharmacist | 2240 Cedar St, Holt, MI 48842-1201 | 2020-02-27 |
| 1083245203 | Hannah Kimpel | Pharmacist | 2240 Cedar St, Holt, MI 48842-1201 | 2020-01-27 |
| 1821635624 | Cherie Reynolds | Pharmacist | 2495 Cedar St, Holt, MI 48842-7400 | 2019-11-30 |
| 1407492689 | Nichole Lynn Veith | Pharmacist | 2495 Cedar St, Holt, MI 48842-7400 | 2019-11-21 |
| Find all providers in HOLT | ||||
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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.