Dougie Fresh Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481283 Issued in PA

Legal business name

DOUGIE FRESH INC

Doing business as

Haeun Pharmacy

Practice address

7300 Old York Rd
Ste 210
Melrose Park, PA 19027-3037

Phone

(215) 635-6532

Fax

(215) 635-2745

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Deog Kim

Title

Owner

Phone

(215) 635-6532

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Haeun Pharmacy Doing business as

Locations

Practitioners 1

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

• Chaehui Tong, RPH

  • Pharmacist
  • Elkins Park, PA
  • NPI 1497342448
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1679659726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 OLD YORK RD",
            "address_2": "STE 210",
            "city": "MELROSE PARK",
            "state": "PA",
            "postal_code": "190273037",
            "telephone_number": "215-635-6532",
            "fax_number": "215-635-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 OLD YORK RD",
            "address_2": "STE 210",
            "city": "MELROSE PARK",
            "state": "PA",
            "postal_code": "190273037",
            "telephone_number": "215-635-6532",
            "fax_number": "215-635-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGIE FRESH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DEOG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-635-6532"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027895800001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138837",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haeun Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Melrose Park, PA
• Providers in Melrose Park, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.