Healthcare Provider Details

I. General information

NPI: 1780976738
Provider Name (Legal Business Name): UNJOUNG KANE PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 E DIXON BLVD
SHELBY NC
28152-6948
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 704-480-9344
  • Fax:
Mailing address:
  • Phone: 704-874-1902
  • Fax: 704-685-4614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11068
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: