Healthcare Provider Details

I. General information

NPI: 1871854406
Provider Name (Legal Business Name): HJK PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 GRAND CONCOURSE FRNT B
BRONX NY
10453-6324
US

IV. Provider business mailing address

1831 GRAND CONCOURSE FRNT B
BRONX NY
10453-6324
US

V. Phone/Fax

Practice location:
  • Phone: 718-466-1000
  • Fax:
Mailing address:
  • Phone: 718-466-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number031323
License Number StateNY

VIII. Authorized Official

Name: HEASOOK KWON
Title or Position: PRESIDENT
Credential:
Phone: 718-466-1000