MEDICARE: JAEHYUK JUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	30047	NC

General Provider Information

NPI Number	:	1114760311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAEHYUK JUNG

Provider Business Mailing Address
First Line	:	2605 LACEBARK PINE RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-9111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 W PEACE ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-5000
Country	:	US
Telephone Number	:	919-334-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2024
Last Update Date	:	06/15/2024

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Directions to “ JAEHYUK JUNG ” Practice Location

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