Active NPI
Boram Jang
- Pharmacist
- Cumming, GA
National Provider Identifier
1306433420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH031999
- Practice address
- 5510 Castleberry Rd
Cumming, GA 30040-8054 - Phone
- (770) 887-7771
- NPI assigned
- Dec 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH031999 | GA | Primary |
Addresses
Primary practice location
5510 Castleberry Rd
Cumming, GA 30040-8054
Mailing address
76 Berkten LN
Lawrenceville, GA 30043-3052
Phone (678) 978-0172
Other names 1
- Bo Jang
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH031999 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| South Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1306433420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 BERKTEN LN",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300433052",
"telephone_number": "678-978-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5510 CASTLEBERRY RD",
"city": "CUMMING",
"state": "GA",
"postal_code": "300408054",
"telephone_number": "770-887-7771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANG",
"first_name": "BORAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-22",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH031999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BO",
"last_name": "JANG",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.