Jeong Eun Park

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH5919 Issued in ND

Practice address

300 11TH St W
White Drug Pharmacy
Williston, ND 58801-5159

Phone

(701) 774-3923

NPI assigned

Dec 23, 2016

Last updated

Dec 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• White Drug Co of Jamestown Inc

  dba Thrifty White Pharmacy #046

  • Community/Retail Pharmacy
  • West Fargo, ND
  • NPI 1033208640
  NPD (past)

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1831634054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 11TH ST W",
            "address_2": "WHITE DRUG PHARMACY",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 11TH ST W",
            "address_2": "WHITE DRUG PHARMACY",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015159",
            "telephone_number": "701-774-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEONG EUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH5919",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "58789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydnee Overton
• Brenda L Owen, LAC, LICSW
• Kristin Pacheco
• Marina Pachuilo
• Lara R Packard, BSN
• Pathology Services
• Kia Patten, MS, CCC-SLP
• Leslie Patterson
• Dana Rae Payne
• Jana Pearson, SLP

• Pharmacist in Williston, ND
• Providers in Williston, ND by specialty
• Pharmacist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.