Chungkang Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CHUNGKANG PHARMACY, LLC

Practice address

14637 Lee Highway, #109B
Centreville, VA 20121

Phone

(571) 655-2393

Fax

(571) 655-2393

NPI assigned

Aug 4, 2016

Reactivated

Apr 29, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Josephine ChungNPI 1366995987

Title

Owner

Phone

(571) 655-2393

Specialties & licenses 1

Addresses

Other names 1

• Centreville Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Josephine Chung, PHARM.D.

  • Pharmacist
  • Chantilly, VA
  • NPI 1366995987
  NPD Authorized official
• Pei-Chieh Lee, PHARMD

  • Ambulatory Care Pharmacist
  • Chantilly, VA
  • NPI 1134634066
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1053865337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14637 LEE HIGHWAY, #109B",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "20121",
            "telephone_number": "571-655-2393",
            "fax_number": "571-655-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14637 LEE HIGHWAY, #109B",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "20121",
            "telephone_number": "571-655-2393",
            "fax_number": "571-655-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUNGKANG PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "deactivation_date": "2019-08-15",
        "reactivation_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-655-2393"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centreville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Yohan Chong, M.D.
• Christine Hart Kress DNP, PLLC
• Young Imkim Chu, ACUPUNCTURIST
• Shue Jen Chuang, D.D.S.
• Eunhwa Chun, RPH
• Nessa-Jade Marie Cinco
• Clear Dental
• Clifton Centreville Medical Associates
• Clifton Foot and Ankle Center P.C.
• Ashleigh Clingenpeel, RN

• Community/Retail Pharmacy in Centreville, VA
• Providers in Centreville, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.