Healthcare Provider Details
I. General information
NPI: 1134989312
Provider Name (Legal Business Name): SEQUON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2024
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
445 E DUBLIN GRANVILLE RD STE 153
WORTHINGTON OH
43085-3192
US
IV. Provider business mailing address
40 WIGHT AVE STE 100
COCKEYSVILLE MD
21030-2148
US
V. Phone/Fax
- Phone: 380-500-1169
- Fax:
- Phone: 667-408-7767
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANDY
HYUN
Title or Position: CEO
Credential:
Phone: 667-408-7767