Active NPI
Bonjoo Koo
- Pharmacist
- Latrobe, PA
National Provider Identifier
1952994501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP442127
- Practice address
- 201 Depot St Ste 200
Latrobe, PA 15650-1802 - Phone
- (800) 338-3688
- NPI assigned
- Feb 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | RP442127 | PA | Primary |
Addresses
Primary practice location
201 Depot St Ste 200
Latrobe, PA 15650-1802
Mailing address
416 Spruce Ave
Upper Darby, PA 19082-2118
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP442127 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613347200000",
"number": "1952994501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 SPRUCE AVE",
"city": "UPPER DARBY",
"state": "PA",
"postal_code": "190822118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 DEPOT ST STE 200",
"city": "LATROBE",
"state": "PA",
"postal_code": "156501802",
"telephone_number": "800-338-3688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOO",
"first_name": "BONJOO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-15",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP442127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latrobe, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.