Active NPI
Derek Dongsuk Lee, PHARM.D.
- Pharmacist
- Phoenix, AZ
National Provider Identifier
1891273173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023350
- Practice address
- 705 E McDowell Rd
Pharmacy
Phoenix, AZ 85006-2519 - Phone
- (602) 258-4865
- NPI assigned
- Jul 30, 2018
- Sex
- Male
- 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 | S023350 | AZ | Primary |
Addresses
Primary practice location
705 E McDowell Rd
Pharmacy
Phoenix, AZ 85006-2519
Mailing address
7716 S Terrace Rd
Tempe, AZ 85284-1559
Phone (617) 894-9984
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S023350 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Phoenix, AZ
- NPI 1356356604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532908800000",
"number": "1891273173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7716 S TERRACE RD",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841559",
"telephone_number": "617-894-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 E MCDOWELL RD",
"address_2": "PHARMACY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062519",
"telephone_number": "602-258-4865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DEREK",
"middle_name": "DONGSUK",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-30",
"last_updated": "2018-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.