Sungchan Lee

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH032362 Issued in GA

Practice address

3625 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4001

Phone

(706) 866-1839

NPI assigned

Oct 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Fort Oglethorpe, GA
  • NPI 1457584559
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1811596273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 FULTON ST APT 353",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374026925",
            "telephone_number": "470-455-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424001",
            "telephone_number": "706-866-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUNGCHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH032362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "3625 Battlefield Pkwy",
            "city": "Fort Oglethorpe",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307424001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ira H Kraus, DPM
• Ken K Kwok, M.D.
• Trisha Lawson
• Lee Family Dentstry, LLC
• Nicole Everett Lee, OTR/L
• Tanner Mitchell Lee
• Graceline Levan, OTD, OTR/L
• Emily Lewis, MS CCC-SLP
• Stephen M Lewis, PA-C
• Lighthouse Kids Hixson, LLC

• All providers in Fort Oglethorpe, GA
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.