Healthcare Provider Details

I. General information

NPI: 1124945696
Provider Name (Legal Business Name): HO SUN PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 AUGUSTA CIR
MOUNT LAUREL NJ
08054-2747
US

IV. Provider business mailing address

1205 AUGUSTA CIR
MOUNT LAUREL NJ
08054-2747
US

V. Phone/Fax

Practice location:
  • Phone: 856-642-1826
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02539900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: