Healthcare Provider Details

I. General information

NPI: 1871743500
Provider Name (Legal Business Name): SANG JO HAN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 S PARK ST STE 600
CARROLLTON GA
30117-4449
US

IV. Provider business mailing address

57 MAYHAW PT
SHARPSBURG GA
30277-6966
US

V. Phone/Fax

Practice location:
  • Phone: 770-214-3146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00060893
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036102
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: