Individual provider Active NPI

Eun Ah Song, RPH

  • Pharmacist
  • Gainesville, VA
National Provider Identifier
1508347733
Registry record updated Aug 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP041405L Issued in PA
Practice address
13842 Litespeed Way
Gainesville, VA 20155-3357
Phone
(719) 373-8379
NPI assigned
Aug 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP041405L PA Primary

Addresses

Primary practice location

13842 Litespeed Way
Gainesville, VA 20155-3357

Mailing address

13842 Litespeed Way
Gainesville, VA 20155-3357
Phone (719) 373-8379

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP041405LPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1535155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535155200000",
    "number": "1508347733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13842 LITESPEED WAY",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553357",
            "telephone_number": "719-373-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13842 LITESPEED WAY",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553357",
            "telephone_number": "719-373-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "EUN AH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-25",
        "last_updated": "2018-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP041405L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2018; 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.